Department of Radiology, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai, 200433, China.
Department of Colorectal Surgery, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai, 200433, China.
Int J Colorectal Dis. 2023 Feb 15;38(1):40. doi: 10.1007/s00384-023-04330-y.
To measure the diagnostic performance of modified MRI-based split scar sign (mrSSS) score for the prediction of pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) for patients with rectal cancer.
The modified MRI-based split scar sign (mrSSS) score, which consists of T2-weighted images (T2WI)-based score and diffusion-weighted images (DWI)-based score. The sensitivity, specificity, and accuracy of modified mrSSS score, endoscopic gross type, and MRI-based tumor regression grading (mrTRG) score, in the prediction of pCR, were compared. The prognostic value of the modified mrSSS score was also studied.
A total of 189 patients were included in the study. The Kendall's coefficient of interobserver concordance of modified mrSSS score, T2WI -based score, and DWI-based score were 0.899, 0.890, and 0.789 respectively. And the maximum and minimum k value of the modified mrSSS score was 0.797 (0.742-0.853) and 0.562 (0.490-0.634). The sensitivity, specificity, and accuracy of prediction of pCR were 0.66, 0.97, and 0.90 for modified mrSSS score; 0.37, 0.89, and 0.78 for endoscopic gross type (scar); and 0.24, 0.92, and 0.77 for mrTRG score (mrTRG = 1). The modified mrSSS score had significantly higher sensitivity than the endoscopic gross type and the mrTRG score in predicting pCR. Patients with lower modified mrSSS scores had significantly longer disease-free survival (P < 0.05).
The modified mrSSS score showed satisfactory interobserver agreement and higher sensitivity in predicting pCR after nCRT in patients with rectal cancer. The modified mrSSS score is also a predictor of disease-free survival.
测量改良 MRI 分割瘢痕征（mrSSS）评分对直肠癌新辅助放化疗（nCRT）后病理完全缓解（pCR）的预测诊断性能。
改良 MRI 分割瘢痕征（mrSSS）评分包括 T2 加权图像（T2WI）评分和弥散加权图像（DWI）评分。比较改良 mrSSS 评分、内镜大体类型和 MRI 肿瘤消退分级（mrTRG）评分在预测 pCR 中的敏感性、特异性和准确性。还研究了改良 mrSSS 评分的预后价值。
本研究共纳入 189 例患者。改良 mrSSS 评分、T2WI 评分和 DWI 评分的观察者间一致性 Kendall 系数分别为 0.899、0.890 和 0.789。改良 mrSSS 评分的最大和最小 k 值分别为 0.797（0.742-0.853）和 0.562（0.490-0.634）。改良 mrSSS 评分预测 pCR 的敏感性、特异性和准确性分别为 0.66、0.97 和 0.90；内镜大体类型（瘢痕）为 0.37、0.89 和 0.78；mrTRG 评分（mrTRG=1）为 0.24、0.92 和 0.77。改良 mrSSS 评分预测 pCR 的敏感性明显高于内镜大体类型和 mrTRG 评分。改良 mrSSS 评分较低的患者无疾病生存时间明显延长（P<0.05）。
改良 mrSSS 评分对预测直肠癌 nCRT 后 pCR 具有良好的观察者间一致性和更高的敏感性。改良 mrSSS 评分也是无病生存的预测因子。
