Department of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan.
Department of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Clin Colorectal Cancer. 2017 Sep;16(3):187-194. doi: 10.1016/j.clcc.2017.01.010. Epub 2017 Jan 25.
We sought to test the effectiveness of the application of a tailored anterior saturation band (ASB) to improve the image quality of pelvic magnetic resonance imaging (MRI) for assessing rectal cancer.
A total of 165 patients with MRI assessment of rectal cancer between 2013 and 2015 were included. The image quality scores (4-point scale: 1, nondiagnostic through 4, excellent) of MRI without and with tailored ASBs were compared. Sensitivity, specificity, positive and negative predictive values, and accuracy of pelvic MRIs with and without a tailored ASB for T-staging in 65 patients with direct surgery and 67 patients with chemoradiotherapy before surgery were evaluated.
Two independent raters exhibited moderate-to-excellent interobserver agreements (κ = 0.529-0.879) in the grading of MRI image quality. Overall, the quality scores of sagittal and axial T2-weighted images with tailored ASBs were significantly improved compared with MRIs without ASBs (3.5 ± 0.3 vs. 2.7 ± 0.8 [mean ± SD]; P < .001, and 3.6 ± 0.3 vs. 2.8 ± 0.8; P < .001, respectively). The application of tailored ASBs in MRIs improved the averaged accuracies for staging of ≤ T2, T3, and T4 tumors from 87.7%, 78.5%, and 90.8% to 93.1%, 86.9%, and 97.7%, respectively. In post-chemoradiotherapy MRI follow-ups, the use of tailored ASBs also improved the average accuracies for staging of yT0, yT1-2, yT3, and yT4 tumors from 80.6%, 73.1%, 73.9%, and 91.0%, to 85.8%, 82.9%, 85.1%, and 94.0%, respectively.
Application of a tailored ASB in pelvic MRI is effective in substantially reducing motion artifacts, significantly upgrading image quality, and improving accuracies of rectal tumor staging.
我们旨在测试应用定制前饱和带（ASB）以改善用于评估直肠癌的盆腔磁共振成像（MRI）图像质量的效果。
共纳入 2013 年至 2015 年期间进行 MRI 评估的 165 例直肠癌患者。比较了无定制 ASB 和有定制 ASB 的 MRI 的图像质量评分（4 分制：1 分为无诊断性，4 分为极好）。评估了 65 例直接手术和 67 例术前放化疗患者的盆腔 MRI 有无定制 ASB 对 T 分期的敏感性、特异性、阳性和阴性预测值及准确性。
两名独立的评估者在 MRI 图像质量分级方面表现出中等至极好的观察者间一致性（κ=0.529-0.879）。总体而言，与无 ASB 的 MRI 相比，定制 ASB 的矢状面和轴位 T2 加权图像的质量评分显著提高（3.5±0.3 与 2.7±0.8[均值±标准差]；P<0.001，和 3.6±0.3 与 2.8±0.8；P<0.001）。在 MRI 分期中应用定制 ASB 可将≤T2、T3 和 T4 肿瘤分期的平均准确率从 87.7%、78.5%和 90.8%提高到 93.1%、86.9%和 97.7%。在放化疗后 MRI 随访中，使用定制 ASB 还将 yT0、yT1-2、yT3 和 yT4 肿瘤分期的平均准确率从 80.6%、73.1%、73.9%和 91.0%提高到 85.8%、82.9%、85.1%和 94.0%。
在盆腔 MRI 中应用定制 ASB 可有效减少运动伪影，显著提高图像质量，并提高直肠肿瘤分期的准确性。
