MR Imaging and Nodal Disease in Rectal Cancer
Author Information
Author(s): Koh Dow-Mu, Smith Neil J., Swift R. Ian, Brown Gina
Primary Institution: Royal Marsden Hospital, U.K.
Hypothesis
MR evidence of extramural venous invasion may act as a surrogate marker for lymphatic permeation by tumor.
Conclusion
An EMVI score of greater than 2 on T2-weighted MR imaging has high sensitivity and specificity for identifying extramural venous invasion, but only moderate sensitivity for predicting nodal involvement.
Supporting Evidence
- An MR score of >2 had 100% sensitivity and 89% specificity for identifying EMVI involving veins >3 mm in diameter.
- An EMVI score of >2 had a sensitivity of 56% and specificity of 81% for identifying patients with stage N2 disease.
- The study included 79 consecutive patients with rectal cancer who underwent primary surgery without neoadjuvant treatment.
Takeaway
Doctors used special MRI scans to see if cancer had spread into nearby veins, which can help predict if it has also spread to lymph nodes.
Methodology
The study reviewed MR imaging of 79 patients with rectal cancer who underwent surgery, scoring for extramural venous invasion and comparing with histopathology.
Limitations
The MR grading of EMVI was not directly compared with histopathology, and node-by-node comparison was not undertaken.
Participant Demographics
42 males and 37 females with a mean age of 67.8 years.
Statistical Information
Confidence Interval
95% CI: 77%–100%
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