Department of Surgery, University Hospital of Larissa, Biopolis Campus, 41110, Larissa, Greece.
Department of Radiology, University Hospital of Larissa, Biopolis Campus, 41110, Larissa, Greece.
Sci Rep. 2024 Jul 26;14(1):17145. doi: 10.1038/s41598-024-68147-7.
The aim of this study is to compare the diagnostic performance of magnetic resonance imaging (MRI) against computed tomography (CT) in various aspects of local staging in colon cancer patients. This study was a prospective single arm diagnostic accuracy study. All consecutive adult patients with confirmed colon cancer that met the current criteria for surgical resection were considered as eligible. Diagnostic performance assessment included T (T1/T2 vs T3/T4 and < T3ab vs > T3cd) and N (N positive) staging, serosa and retroperitoneal surgical margin (RSM) involvement and extramural vascular invasion (EMVI). Imaging was based on a 3 Tesla MRI system and the evaluation of all sequences (T1, T2 and diffusion-weighted imaging-DWI series) by two independent readers. CT scan was performed in a 128 row multidetector (MD) CT scanner (slice thickness: 1 mm) with intravenous contrast. Pathology report was considered as the gold standard for local staging. Sensitivity (SE), specificity (SP), and area under the curve (AUC) were calculated for both observers. MRI displayed a higher diagnostic performance over CT in terms of T1/T2 vs T3/T4 (SE: 100% vs 83.9%, SP: 96.6% vs 81%, AUC: 0.825 vs 0.983, p < 0.001), N positive (p < 0.001) and EMVI (p = 0.023) assessment. An excellent performance of MRI was noted in the T3ab vs T3cd (CT AUC: 0.636, AUC: 0.55 vs MRI AUC: 0.829 AUC 0.846, p = 0.01) and RSM invasion diagnosis. In contrast to these, MRI did not perform well in the identification of serosa invasion. MRI had a higher diagnostic yield than CT in several local staging parameters.
本研究旨在比较磁共振成像（MRI）与计算机断层扫描（CT）在结肠癌患者局部分期的各个方面的诊断性能。这是一项前瞻性单臂诊断准确性研究。所有符合当前手术切除标准的经证实患有结肠癌的连续成年患者均被视为符合条件。诊断性能评估包括 T（T1/T2 与 T3/T4 及＜T3ab 与＞T3cd）和 N（N 阳性）分期、浆膜和腹膜后手术切缘（RSM）侵犯和外膜血管侵犯（EMVI）。成像基于 3 Tesla MRI 系统，由两名独立的读者评估所有序列（T1、T2 和弥散加权成像-DWI 系列）。CT 扫描在 128 排多层（MD）CT 扫描仪上进行（层厚：1mm），静脉内注射造影剂。局部分期的金标准是病理报告。计算了两位观察者的敏感度（SE）、特异度（SP）和曲线下面积（AUC）。MRI 在 T1/T2 与 T3/T4（SE：100% 与 83.9%，SP：96.6% 与 81%，AUC：0.825 与 0.983，p＜0.001）、N 阳性（p＜0.001）和 EMVI（p=0.023）评估方面显示出比 CT 更高的诊断性能。MRI 在 T3ab 与 T3cd（CT AUC：0.636，AUC：0.55 与 MRI AUC：0.829 AUC 0.846，p=0.01）和 RSM 侵犯诊断方面表现出色。与此相反，MRI 在识别浆膜侵犯方面表现不佳。MRI 在几个局部分期参数方面的诊断效果优于 CT。
