结直肠癌腹膜转移分期：MRI、手术和组织病理学腹膜癌指数之间的相关性。
Staging peritoneal metastases in colorectal cancer: The correlation between MRI, surgical and histopathological peritoneal cancer index.
机构信息
Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands; GROW School for Oncology and Reproduction - University of Maastricht, Maastricht, the Netherlands.
Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands.
出版信息
Eur J Surg Oncol. 2024 Dec;50(12):108611. doi: 10.1016/j.ejso.2024.108611. Epub 2024 Aug 22.
INTRODUCTION
DW-MRI is a non-invasive way to determine the peritoneal cancer index (PCI) in colorectal cancer (CRC) patients with peritoneal metastases (PM). However, like surgeons during surgery, radiologists struggle to differentiate between PM and fibrosis. This study aimed to investigate the agreement between the PCI as determined by MRI (mriPCI), during surgery (sPCI) and histopathology examination (pPCI) in CRC patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).
MATERIALS AND METHODS
This was a single-centre, retrospective study of CRC patients with PM who were staged with DW-MRI and underwent subsequent CRS-HIPEC. All initial patients' radiological, surgical and histopathology reports were reviewed for the PCI. Histopathology was the reference standard. Primary outcome was the correlation and agreement between mriPCI and pPCI.
RESULTS
Eighty-seven patients were included. All patients had a complete macroscopic resection. Median (interquartile range) PCI for MRI, surgery, and histopathology were respectively 6.0 (2.5-9.0), 6.0 (4.0-11.0) and 6.0 (2.5-9.5). The intraclass correlation coefficient between the sPCI and pPCI was excellent 0.87 (p <0.001), and good between mriPCI and pPCI 0.77 (p <0.001) and between sPCI and mriPCI 0.70 (p <0.001).
CONCLUSION
MRI is a promising non-invasive tool to assess the PCI rather accurately.
简介
磁共振弥散加权成像（DW-MRI）是一种非侵入性的方法，可以确定结直肠癌（CRC）合并腹膜转移（PM）患者的腹膜癌指数（PCI）。然而，就像外科医生在手术中一样，放射科医生也难以区分 PM 和纤维化。本研究旨在探讨在接受细胞减灭术和腹腔热灌注化疗（CRS-HIPEC）的 CRC 患者中，MRI （mriPCI）、手术（sPCI）和组织病理学检查（pPCI）确定的 PCI 之间的一致性。
材料和方法
这是一项单中心回顾性研究，纳入了经 DW-MRI 分期并随后接受 CRS-HIPEC 的 CRC 合并 PM 患者。所有初始患者的放射学、手术和组织病理学报告均用于评估 PCI。组织病理学是参考标准。主要结局是 mriPCI 和 pPCI 之间的相关性和一致性。
结果
共纳入 87 例患者。所有患者均行完全性肉眼切除术。MRI、手术和组织病理学检查的中位数（四分位数间距）PCI 分别为 6.0（2.5-9.0）、6.0（4.0-11.0）和 6.0（2.5-9.5）。sPCI 和 pPCI 之间的组内相关系数为 0.87（p<0.001），mriPCI 和 pPCI 之间为 0.77（p<0.001），sPCI 和 mriPCI 之间为 0.70（p<0.001）。
结论
MRI 是一种很有前途的非侵入性工具，可以相当准确地评估 PCI。
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