Yonsei University College of Medicine, Seoul, South Korea.
Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
Eur J Surg Oncol. 2019 Mar;45(3):324-330. doi: 10.1016/j.ejso.2018.08.029. Epub 2018 Oct 9.
In measuring tumor height for rectal cancer, rigid sigmoidoscopy (RS) is a standard modality, and the accuracy of magnetic resonance imaging(MRI) in patients with/without preoperative chemoradiotherapy (CRT) has not been fully investigated. The aim of this study was to investigate the accuracy of MRI for measuring tumor height.
Among rectal cancer patients seen between July 2006 and May 2012, the initial group (RS and MRI available at initial diagnosis) and the post-CRT group (RS and MRI available after the completion of preoperative CRT) were selected. Intra-class correlation coefficient (ICC) comparison tests were performed between RS and MRI results for each group.
Ninety-nine and 29 patients were allocated into the initial group and the post-CRT group, respectively. The tumor heights measured by RS and MRI demonstrated a positive relationship in the scatter plot (linear regression; R = 0.898; p < 0.001 in the initial group, R = 0.696; p < 0.001 in the post-CRT group). With respect to difference of absolute value (DAV) between RS and MRI, the overall mean and standard deviation of DAV were 10.9 ± 10 mm in the initial group and 8 ± 6 mm in the post-CRT group. ICC comparison analysis revealed that inter-rater agreement of RS and MRI in the initial group was significantly better than that of the post-CRT group [ICC (95% CI) 0.946 (0.919-0.963) vs. 0.823 (0.621-0.917); p = 0.004)].
MRI can be used as a viable option to measure tumor height in rectal cancer even in patients who have undergone preoperative CRT.
在测量直肠癌肿瘤高度时，刚性乙状结肠镜（RS）是一种标准方式，而 MRI 在接受术前放化疗（CRT）的患者中的准确性尚未得到充分研究。本研究旨在探讨 MRI 测量肿瘤高度的准确性。
在 2006 年 7 月至 2012 年 5 月期间就诊的直肠癌患者中，选择初始组（RS 和 MRI 在初始诊断时可用）和 post-CRT 组（RS 和 MRI 在术前 CRT 完成后可用）。对每组 RS 和 MRI 结果进行了组内相关系数（ICC）比较检验。
99 例和 29 例患者分别被分配到初始组和 post-CRT 组。RS 和 MRI 测量的肿瘤高度在散点图中呈正相关（线性回归；初始组 R=0.898；p<0.001，post-CRT 组 R=0.696；p<0.001）。对于 RS 和 MRI 之间的绝对值差异（DAV），初始组的 DAV 平均值和标准差为 10.9±10mm，post-CRT 组为 8±6mm。ICC 比较分析显示，初始组 RS 和 MRI 的组内一致性明显优于 post-CRT 组[ICC（95%CI）0.946（0.919-0.963）vs.0.823（0.621-0.917）；p=0.004）]。
即使在接受术前 CRT 的患者中，MRI 也可以作为测量直肠癌肿瘤高度的可行选择。
