Borgheresi Alessandra, De Muzio Federica, Agostini Andrea, Ottaviani Letizia, Bruno Alessandra, Granata Vincenza, Fusco Roberta, Danti Ginevra, Flammia Federica, Grassi Roberta, Grassi Francesca, Bruno Federico, Palumbo Pierpaolo, Barile Antonio, Miele Vittorio, Giovagnoni Andrea
Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy.
Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy.
J Clin Med. 2022 May 5;11(9):2599. doi: 10.3390/jcm11092599.
The assessment of nodal involvement in patients with rectal cancer (RC) is fundamental in disease management. Magnetic Resonance Imaging (MRI) is routinely used for local and nodal staging of RC by using morphological criteria. The actual dimensional and morphological criteria for nodal assessment present several limitations in terms of sensitivity and specificity. For these reasons, several different techniques, such as Diffusion Weighted Imaging (DWI), Intravoxel Incoherent Motion (IVIM), Diffusion Kurtosis Imaging (DKI), and Dynamic Contrast Enhancement (DCE) in MRI have been introduced but still not fully validated. Positron Emission Tomography (PET)/CT plays a pivotal role in the assessment of LNs; more recently PET/MRI has been introduced. The advantages and limitations of these imaging modalities will be provided in this narrative review. The second part of the review includes experimental techniques, such as iron-oxide particles (SPIO), and dual-energy CT (DECT). Radiomics analysis is an active field of research, and the evidence about LNs in RC will be discussed. The review also discusses the different recommendations between the European and North American guidelines for the evaluation of LNs in RC, from anatomical considerations to structured reporting.
评估直肠癌（RC）患者的淋巴结受累情况是疾病管理的基础。磁共振成像（MRI）通常利用形态学标准对RC进行局部和淋巴结分期。淋巴结评估的实际尺寸和形态学标准在敏感性和特异性方面存在若干局限性。基于这些原因，已引入了几种不同的技术，如MRI中的扩散加权成像（DWI）、体素内不相干运动（IVIM）、扩散峰度成像（DKI）和动态对比增强（DCE），但仍未得到充分验证。正电子发射断层扫描（PET）/CT在淋巴结评估中起着关键作用；最近又引入了PET/MRI。本叙述性综述将介绍这些成像方式的优缺点。综述的第二部分包括实验技术，如氧化铁颗粒（SPIO）和双能CT（DECT）。放射组学分析是一个活跃的研究领域，将讨论有关RC中淋巴结的证据。该综述还讨论了欧洲和北美指南在RC淋巴结评估方面的不同建议，从解剖学考虑到结构化报告。
