Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study

Medientyp: E-Artikel
Titel: Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study
Beteiligte: El Khababi, Najim; Beets-Tan, Regina G. H.; Tissier, Renaud; Lahaye, Max J.; Maas, Monique; Curvo-Semedo, Luís; Dresen, Raphaëla C.; Nougaret, Stephanie; Beets, Geerard L.; Lambregts, Doenja M. J.; Bakers, Frans C. H.; Barros, Perla; Bauer, Ferdinand; de Bie, Shira H; Ballantyne, Stuart; Dutra, Joanna Brayner; Buskov, Laura; Bogveradze, Nino; Bosma, Gerlof P. T.; Cappendijk, Vincent C; Castagnoli, Francesca; Charalampos, Sotiriadis; Delli Pizzi, Andrea; Digby, Michael; [...]
Erschienen: Springer Science and Business Media LLC, 2023
Erschienen in: Abdominal Radiology
Sprache: Englisch
DOI: 10.1007/s00261-023-03961-7
ISSN: 2366-0058
Schlagwörter: Urology ; Gastroenterology ; Radiology, Nuclear Medicine and imaging ; Radiological and Ultrasound Technology
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Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Purpose</jats:title> <jats:p>Pre-treatment knowledge of the anticipated response of rectal tumors to neoadjuvant chemoradiotherapy (CRT) could help to further optimize the treatment. Van Griethuysen et al. proposed a visual 5-point confidence score to predict the likelihood of response on baseline MRI. Aim was to evaluate this score in a multicenter and multireader study setting and compare it to two simplified (4-point and 2-point) adaptations in terms of diagnostic performance, interobserver agreement (IOA), and reader preference.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Twenty-two radiologists from 14 countries (5 MRI-experts,17 general/abdominal radiologists) retrospectively reviewed 90 baseline MRIs to estimate if patients would likely achieve a (near-)complete response (nCR); first using the 5-point score by van Griethuysen (1=highly unlikely to 5=highly likely to achieve nCR), second using a 4-point adaptation (with 1-point each for high-risk T-stage, obvious mesorectal fascia invasion, nodal involvement, and extramural vascular invasion), and third using a 2-point score (unlikely/likely to achieve nCR). Diagnostic performance was calculated using ROC curves and IOA using Krippendorf’s alpha (<jats:italic>α</jats:italic>).</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Areas under the ROC curve to predict the likelihood of a nCR were similar for the three methods (0.71–0.74). IOA was higher for the 5- and 4-point scores (<jats:italic>α</jats:italic>=0.55 and 0.57 versus 0.46 for the 2-point score) with best results for the MRI-experts (<jats:italic>α</jats:italic>=0.64-0.65). Most readers (55%) favored the 4-point score.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Visual morphologic assessment and staging methods can predict neoadjuvant treatment response with moderate–good performance. Compared to a previously published confidence-based scoring system, study readers preferred a simplified 4-point risk score based on high-risk T-stage, MRF involvement, nodal involvement, and EMVI.</jats:p> </jats:sec><jats:sec> <jats:title>Graphical abstract</jats:title> </jats:sec>

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