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Comparison of magnetic resonance imaging and histopathological response to chemoradiotherapy in locally advanced rectal cancer

Uday Bharat Patel, Gina Brown, Harm Rutten, Nicholas West, David Sebag-Montefiore, Robert Glynne-Jones, Eric Rullier, Marc Peeters (UGent) , Eric Van Cutsem, Sergio Ricci, et al.
(2012) ANNALS OF SURGICAL ONCOLOGY. 19(9). p.2842-2852
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Abstract
Magnetic resonance imaging (MRI) methods for chemoradiotherapy (CRT) response assessment of rectal cancer include posttreatment T staging (ymrT), tumor regression grading (mrTRG), volume reduction posttreatment, and modified RECIST measurement. We compared these methods in identifying good versus poor responders with the histopathological standards of T stage (ypT) and tumor regression grading (TRG). A total of 86 patients underwent CRT in a prospective phase II trial for MRI-defined locally advanced rectal cancer. Two readers independently assessed MRIs for ymrT, mrTRG, volume change, and RECIST. Parameters for each case were categorized as good or poor response and analyzed against ypT and TRG by univariate logistic regression. A total of 83 patients had evaluable imaging, and 78 had final pathology (five did not undergo surgery). Of these, 34 patients had good response (ypT0-3a) and 44 had poor response (> ypT3a). Also, 27 patients had favorable pathologic TRG (predominant fibrosis) and 51 had unfavorable TRG (predominant tumor). Good mrTRG and ymr < T3b stage were both significantly (P = 0.001) associated with favorable pathology odds ratio [OR] = 16.11 (95 % confidence interval [95 % CI]: 3.36-77.29) and 17.50 (95 % CI: 5.38-56.89), respectively. RECIST measurements and volume reduction of > 80 % showed an OR of 3.23 (95 % CI: 1.14-9.17), 4.25 (95 % CI: 0.92-15.45), respectively, for a good ypT score (P = 0.028), but there was no association for histopathological TRG. Favorable and unfavorable histopathology are predicted by both ymrT and mrTRG, and we recommend these parameters for post-treatment assessment of rectal cancers treated with CRT.
Keywords
DISEASE-FREE SURVIVAL, PREOPERATIVE CHEMORADIATION, NONOPERATIVE TREATMENT, RADIATION-THERAPY, PATHOLOGICAL RESPONSE, TUMOR VOLUME, MR, CHEMOTHERAPY, RADIOCHEMOTHERAPY, PREDICTION

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MLA
Patel, Uday Bharat, et al. “Comparison of Magnetic Resonance Imaging and Histopathological Response to Chemoradiotherapy in Locally Advanced Rectal Cancer.” ANNALS OF SURGICAL ONCOLOGY, vol. 19, no. 9, 2012, pp. 2842–52, doi:10.1245/s10434-012-2309-3.
APA
Patel, U. B., Brown, G., Rutten, H., West, N., Sebag-Montefiore, D., Glynne-Jones, R., … Quirke, P. (2012). Comparison of magnetic resonance imaging and histopathological response to chemoradiotherapy in locally advanced rectal cancer. ANNALS OF SURGICAL ONCOLOGY, 19(9), 2842–2852. https://doi.org/10.1245/s10434-012-2309-3
Chicago author-date
Patel, Uday Bharat, Gina Brown, Harm Rutten, Nicholas West, David Sebag-Montefiore, Robert Glynne-Jones, Eric Rullier, et al. 2012. “Comparison of Magnetic Resonance Imaging and Histopathological Response to Chemoradiotherapy in Locally Advanced Rectal Cancer.” ANNALS OF SURGICAL ONCOLOGY 19 (9): 2842–52. https://doi.org/10.1245/s10434-012-2309-3.
Chicago author-date (all authors)
Patel, Uday Bharat, Gina Brown, Harm Rutten, Nicholas West, David Sebag-Montefiore, Robert Glynne-Jones, Eric Rullier, Marc Peeters, Eric Van Cutsem, Sergio Ricci, Cornelius Van de Velde, Pennert Kjell, and Philip Quirke. 2012. “Comparison of Magnetic Resonance Imaging and Histopathological Response to Chemoradiotherapy in Locally Advanced Rectal Cancer.” ANNALS OF SURGICAL ONCOLOGY 19 (9): 2842–2852. doi:10.1245/s10434-012-2309-3.
Vancouver
1.
Patel UB, Brown G, Rutten H, West N, Sebag-Montefiore D, Glynne-Jones R, et al. Comparison of magnetic resonance imaging and histopathological response to chemoradiotherapy in locally advanced rectal cancer. ANNALS OF SURGICAL ONCOLOGY. 2012;19(9):2842–52.
IEEE
[1]
U. B. Patel et al., “Comparison of magnetic resonance imaging and histopathological response to chemoradiotherapy in locally advanced rectal cancer,” ANNALS OF SURGICAL ONCOLOGY, vol. 19, no. 9, pp. 2842–2852, 2012.
@article{3226930,
  abstract     = {{Magnetic resonance imaging (MRI) methods for chemoradiotherapy (CRT) response assessment of rectal cancer include posttreatment T staging (ymrT), tumor regression grading (mrTRG), volume reduction posttreatment, and modified RECIST measurement. We compared these methods in identifying good versus poor responders with the histopathological standards of T stage (ypT) and tumor regression grading (TRG). 
A total of 86 patients underwent CRT in a prospective phase II trial for MRI-defined locally advanced rectal cancer. Two readers independently assessed MRIs for ymrT, mrTRG, volume change, and RECIST. Parameters for each case were categorized as good or poor response and analyzed against ypT and TRG by univariate logistic regression. 
A total of 83 patients had evaluable imaging, and 78 had final pathology (five did not undergo surgery). Of these, 34 patients had good response (ypT0-3a) and 44 had poor response (> ypT3a). Also, 27 patients had favorable pathologic TRG (predominant fibrosis) and 51 had unfavorable TRG (predominant tumor). Good mrTRG and ymr < T3b stage were both significantly (P = 0.001) associated with favorable pathology odds ratio [OR] = 16.11 (95 % confidence interval [95 % CI]: 3.36-77.29) and 17.50 (95 % CI: 5.38-56.89), respectively. RECIST measurements and volume reduction of > 80 % showed an OR of 3.23 (95 % CI: 1.14-9.17), 4.25 (95 % CI: 0.92-15.45), respectively, for a good ypT score (P = 0.028), but there was no association for histopathological TRG. 
Favorable and unfavorable histopathology are predicted by both ymrT and mrTRG, and we recommend these parameters for post-treatment assessment of rectal cancers treated with CRT.}},
  author       = {{Patel, Uday Bharat and Brown, Gina and Rutten, Harm and West, Nicholas and Sebag-Montefiore, David and Glynne-Jones, Robert and Rullier, Eric and Peeters, Marc and Van Cutsem, Eric and Ricci, Sergio and Van de Velde, Cornelius and Kjell, Pennert and Quirke, Philip}},
  issn         = {{1068-9265}},
  journal      = {{ANNALS OF SURGICAL ONCOLOGY}},
  keywords     = {{DISEASE-FREE SURVIVAL,PREOPERATIVE CHEMORADIATION,NONOPERATIVE TREATMENT,RADIATION-THERAPY,PATHOLOGICAL RESPONSE,TUMOR VOLUME,MR,CHEMOTHERAPY,RADIOCHEMOTHERAPY,PREDICTION}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{2842--2852}},
  title        = {{Comparison of magnetic resonance imaging and histopathological response to chemoradiotherapy in locally advanced rectal cancer}},
  url          = {{http://doi.org/10.1245/s10434-012-2309-3}},
  volume       = {{19}},
  year         = {{2012}},
}
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