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MRI in local advanced rectal

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https://www.readbyqxmd.com/read/28851403/a-rectal-cancer-feasibility-study-with-an-embedded-phase-iii-trial-design-assessing-magnetic-resonance-tumour-regression-grade-mrtrg-as-a-novel-biomarker-to-stratify-management-by-good-and-poor-response-to-chemoradiotherapy-trigger-study-protocol-for-a-randomised
#1
Nick J Battersby, Mit Dattani, Sheela Rao, David Cunningham, Diana Tait, Richard Adams, Brendan J Moran, Shelize Khakoo, Paris Tekkis, Shahnawaz Rasheed, Alex Mirnezami, Philip Quirke, Nicholas P West, Iris Nagtegaal, Irene Chong, Anguraj Sadanandam, Nicola Valeri, Karen Thomas, Michelle Frost, Gina Brown
BACKGROUND: Pre-operative chemoradiotherapy (CRT) for MRI-defined, locally advanced rectal cancer is primarily intended to reduce local recurrence rates by downstaging tumours, enabling an improved likelihood of curative resection. However, in a subset of patients complete tumour regression occurs implying that no viable tumour is present within the surgical specimen. This raises the possibility that surgery may have been avoided. It is also recognised that response to CRT is a key determinant of prognosis...
August 29, 2017: Trials
https://www.readbyqxmd.com/read/28757404/intermediate-dose-volume-parameters-and-the-development-of-late-rectal-toxicity-after-mri-guided-brachytherapy-for-locally-advanced-cervix-cancer
#2
Reem Ujaimi, Michael Milosevic, Anthony Fyles, Akbar Beiki-Ardakani, Marco Carlone, Haiyan Jiang, Patricia Lindsay, Jason Xie, Rachel Gerber, Jennifer Croke, Julia Skliarenko, Wilfred Levin, Kathy Han
PURPOSE: The dose delivered to the most exposed 2 cm(3) [Formula: see text] of the rectum and bladder is predictive of late rectal and bladder toxicity in cervix cancer patients. We investigated the predictive value of intermediate doses to the rectum and bladder for late rectal/bladder toxicity after MRI-guided brachytherapy for patients with locally advanced cervix cancer. METHODS AND MATERIALS: Toxicity was prospectively graded using Common Toxicity Criteria for Adverse Events v4...
July 27, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28717704/significance-of-magnetic-resonance-imaging-assessed-tumor-response-for-locally-advanced-rectal-cancer-treated-with-preoperative-long-course-chemoradiation
#3
Mohamed Salah Fayaz, Gerges Attia Demian, Wael Moftah Fathallah, Heba El-Sayed Eissa, Mustafa Shawki El-Sherify, Sadeq Abozlouf, Thomas George, Suzanne Mona Samir
PURPOSE: To study the predictive and prognostic value of magnetic resonance imaging (MRI)-assessed tumor response after long-course neoadjuvant therapy for locally advanced rectal cancer. METHODS: This study included 79 patients who had T3 or T4 and/or N+ rectal cancer treated with long-course neoadjuvant chemoradiation. MRI-assessed tumor regression grade (mrTRG) was assessed in 64 patients. MRIs were reviewed by the study radiologist. Surgical and pathologic reports for those who underwent surgery were reviewed...
August 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28706185/deep-learning-for-fully-automated-localization-and-segmentation-of-rectal-cancer-on-multiparametric-mr
#4
Stefano Trebeschi, Joost J M van Griethuysen, Doenja M J Lambregts, Max J Lahaye, Chintan Parmer, Frans C H Bakers, Nicky H G M Peters, Regina G H Beets-Tan, Hugo J W L Aerts
Multiparametric Magnetic Resonance Imaging (MRI) can provide detailed information of the physical characteristics of rectum tumours. Several investigations suggest that volumetric analyses on anatomical and functional MRI contain clinically valuable information. However, manual delineation of tumours is a time consuming procedure, as it requires a high level of expertise. Here, we evaluate deep learning methods for automatic localization and segmentation of rectal cancers on multiparametric MR imaging. MRI scans (1...
July 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28676107/study-protocol-multi-parametric-magnetic-resonance-imaging-for-therapeutic-response-prediction-in-rectal-cancer
#5
Trang Thanh Pham, Gary Liney, Karen Wong, Robba Rai, Mark Lee, Daniel Moses, Christopher Henderson, Michael Lin, Joo-Shik Shin, Michael Bernard Barton
BACKGROUND: Response to neoadjuvant chemoradiotherapy (CRT) of rectal cancer is variable. Accurate imaging for prediction and early assessment of response would enable appropriate stratification of management to reduce treatment morbidity and improve therapeutic outcomes. Use of either diffusion weighted imaging (DWI) or dynamic contrast enhanced (DCE) imaging alone currently lacks sufficient sensitivity and specificity for clinical use to guide individualized treatment in rectal cancer...
July 4, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28638791/magnetic-resonance-imaging-for-diagnosis-and-neoadjuvant-treatment-evaluation-in-locally-advanced-rectal-cancer-a-pictorial-review
#6
REVIEW
Gulgun Engin, Rasul Sharifov
High-resolution pelvic magnetic resonance imaging (MRI) is the primary method for staging rectal cancer. MRI is highly accurate in the primary staging of rectal cancer; however, it has not proven to be effective in re-staging, especially in complete response evaluation after neoadjuvant therapy. Neoadjuvant chemoradiotherapy produces many changes in rectal tumors and on adjacent area, as a result, local tumor extent may not be accurately determined. However, adding diffusion-weighted sequences to the standard approach can improve diagnostic accuracy...
June 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28594719/bowel-dysfunction-after-low-anterior-resection-with-neoadjuvant-chemoradiotherapy-or-chemotherapy-alone-for-rectal-cancer-a-cross-sectional-study-from-china
#7
Qiyuan Qin, Binjie Huang, Wuteng Cao, Jie Zhou, Tenghui Ma, Zhiyang Zhou, Jianping Wang, Lei Wang
BACKGROUND: Neoadjuvant therapy plays a vital role in the treatment of locally advanced rectal cancer but impairs bowel function after restorative surgery. Optimal decision making requires adequate information of functional outcomes. OBJECTIVE: This study aimed to assess postoperative bowel function and to identify predictors for severe dysfunction. DESIGN: The study included a cross-sectional cohort and retrospective assessments of pelvic anatomic features...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28534328/-predictive-value-of-serum-carcinoembryonic-antigen-level-in-efficacy-and-prognosis-for-patients-with-rectal-cancer-following-preoperative-radiochemotherapy
#8
Dakui Zhang, Tiancheng Zhan, Ming Li, Jin Gu
OBJECTIVE: To examine the association of preoperative carcinoembryonic antigen (CEA) level with the efficacy of neoadjuvant radiochemotherapy and postoperative metastasis and relapse in patients with rectal cancer. METHODS: Between January 2011 and January 2014, 325 patients with local advanced rectal cancer underwent preoperative radiochemotherapy and radical operation in Department of Colorectal Cancer Surgery, Beijing University Cancer Hospital, including 194 males and 131 females...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28534322/-value-of-functional-magnetic-resonance-imaging-in-predicting-outcomes-of-neoadjuvant-chemoradiotherapy-in-rectal-cancer
#9
Yishan Yu, Jinbo Yue, Jinming Yu
Rectal cancer is one of the common cancers which poses a threat to the health of mankind. In recent years. Multi-modality treatment strategies for locally advanced rectal cancer improve the treatment efficiency. Accurate prediction of the treatment response after the neoadjuvant chemoradiotherapy (CRT) can guide more suitable treatment strategy. MERCURY study proved the prognostic value of post-CRT standard morphologic MRI(T2-weighted) assessment of tumor regression grade(TRG), and MRI assessment of circumferential resection margin can guide the definitive surgery...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28514763/the-value-of-diffusion-kurtosis-imaging-in-assessing-pathological-complete-response-to-neoadjuvant-chemoradiation-therapy-in-rectal-cancer-a-comparison-with-conventional-diffusion-weighted-imaging
#10
Feixiang Hu, Wei Tang, Yiqun Sun, Dang Wan, Sanjun Cai, Zhen Zhang, Robert Grimm, Xu Yan, Caixia Fu, Tong Tong, Weijun Peng
OBJECTIVES: The aim of this study is to comprehensively evaluate the advantage of diffusion kurtosis imaging (DKI) in distinguishing pathological complete response (pCR) from non-pCR patients with locally advanced rectal cancer (LARC) after neoadjuvant chemoradiation therapy (CRT) in comparison to conventional diffusion-weighted imaging (DWI). MATERIAL AND METHODS: Fifty-six consecutive patients diagnosed with LARC were prospectively enrolled and underwent pre- and post-CRT MRI on a 3...
April 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28507455/neoadjuvant-chemoradiotherapy-of-the-rectal-carcinoma-the-correlation-between-the-findings-on-the-restaging-multiparametric-3t-mri-scanning-and-the-surgical-findings
#11
Radovan Vojtíšek, Eva Korčáková, Jan Mařan, Ondřej Šorejs, Jindřich Fínek
AIM: To figure out how to correlate the findings on functional MRI and carried out after neoadjuvant CRT of rectal carcinoma with final histology after surgery. BACKGROUND: Neoadjuvant CRT is the standard treatment of locally advanced rectal carcinoma. Its use leads to the downstaging of the disease and in 15-42% of patients even to the detection of pCR after TME. The use of functional MRI improves the sensitivity and specificity of pCR detection up to 52-64% and 89-98%, respectively...
July 2017: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/28488380/addition-of-oxaliplatin-to-neoadjuvant-radiochemotherapy-in-mri-defined-t3-t4-or-n-rectal-cancer-a-randomized-clinical-trial
#12
Peiman Haddad, Monir Miraie, Farshid Farhan, Mohammad-Sadegh Fazeli, Afsaneh Alikhassi, Afsaneh Maddah-Safaei, Mahdi Aghili, Bita Kalaghchi, Mohammad Babaei
BACKGROUND: Clinical trials investigating the effects of addition of oxaliplatin to neoadjuvant radiochemotherapy in locally advanced rectal cancers (LARCs) have brought controversial results for pathologic complete response as an endpoint. This randomized clinical trial investigated downstaging as a short-term surrogate for progression-free survival (PFS). METHODS: Patients with magnetic resonance imaging (MRI) defined T3, T4 or N+ histologically proven adenocarcinoma of rectum within 15 cm from anal verge were randomly assigned to receive 50-50...
May 10, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28481851/what-to-do-with-lateral-nodal-disease-in-low-locally-advanced-rectal-cancer-a-call-for-further-reflection-and-research
#13
Miranda Kusters, Andrew Slater, Rebecca Muirhead, Roel Hompes, Richard J Guy, Oliver M Jones, Bruce D George, Ian Lindsey, Neil J Mortensen, Chris Cunningham
BACKGROUND: There remains a lack of international consensus on the appropriate management of lateral nodal disease. Although the East manages this more aggressively with lateral lymph node dissections, the West aims to eradicate small-volume disease with neoadjuvant chemoradiotherapy and lateral nodal disease is not considered for routine surgical treatment. However, recent studies have shown that, despite neoadjuvant treatment, a significant number of patients with lateral nodal disease develop local recurrence in the lateral compartment after total mesorectal excision...
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28464745/diffusion-weighted-magnetic-resonance-imaging-of-rectal-cancer-tumour-volume-and-perfusion-fraction-predict-chemoradiotherapy-response-and-survival
#14
Kine Mari Bakke, Knut Håkon Hole, Svein Dueland, Krystyna Kotanska Grøholt, Kjersti Flatmark, Anne Hansen Ree, Therese Seierstad, Kathrine Røe Redalen
BACKGROUND: In locally advanced rectal cancer (LARC), responses to preoperative treatment are highly heterogeneous and more accurate diagnostics are likely to enable more individualised treatment approaches with improved responses. We investigated the potential of diffusion-weighted magnetic resonance imaging (DW MRI), with quantification of the apparent diffusion coefficient (ADC) and perfusion fraction (F), as well as volumetry from T2-weighted (T2W) MRI, for prediction of therapeutic outcome...
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28363512/diffusion-weighted-magnetic-resonance-imaging-in-locally-advanced-rectal-cancer-treated-with-neoadjuvant-chemoradiotherapy
#15
F De Felice, A L Magnante, D Musio, M Ciolina, C N De Cecco, M Rengo, A Laghi, V Tombolini
PURPOSE: To analyze diffusion-weighted magnetic resonance imaging (DW-MRI) for treatment response assessment in locally advanced rectal cancer (LARC). PATIENTS AND METHODS: Patients with histologically proven rectal adenocarcinoma, stage II-III disease, were enrolled and underwent surgery following neoadjuvant chemoradiotherapy (nCRT). All patients were referred for a DW-MRI protocol on a 3 Tesla MR-system, consisting of axial T2-weighted and DWI sequences prior (I), during (II) and after (III) nCRT...
July 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28304150/additional-chemotherapy-and-salvage-surgery-for-poor-response-to-chemoradiotherapy-in-rectal-cancers
#16
Reena Engineer, Vikas Ostwal, Supreeta Arya, Priyamvada Gupta, Supriya Chopra, Prachi Patil, Sudhir Jatal, Avanish Saklani
AIM: A proportion of locally advanced rectal cancer patients who receive neoadjuvant chemoradiotherapy (NACRT) are still unresectable. This study was undertaken to assess the outcomes of giving additional chemotherapy to rectal cancer patients with unresectable disease after NACRT. METHODS: Patients with poor response to NACRT where mesorectal fascia was still involved on MRI and R0 resection was doubtful, received additional four cycles of chemotherapy with either CAPOX or FOLFIRINOX regimen, and the response was reevaluated with MRI and reassessed for surgical resection...
August 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28255388/the-evaluation-of-the-oxidative-stress-for-patients-receiving-neoadjuvant-chemoradiotherapy-for-locally-advanced-rectal-cancer
#17
G L Serbanescu, M I Gruia, M Bara, R M Anghel
Hypothesis: Nowadays, rectal cancer is an important healthcare challenge that affects many thousands of people each year worldwide, being diagnosed especially after the age of 50 years. Objective: This study attempted to evaluate the oxidative stress in patients with rectal cancer. Methods and results: 30 patients from the "Prof. Dr. Al. Trestioreanu" Institute of Oncology in Bucharest were treated with neoadjuvant radiochemotherapy during 2014 and 2016 and were included in the clinical study. Blood samples were obtained in dynamics during the treatment...
January 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28179091/rectal-cancer-french-intergroup-clinical-practice-guidelines-for-diagnosis-treatments-and-follow-up-snfge-ffcd-gercor-unicancer-sfcd-sfed-sfro
#18
Jean-Pierre Gérard, Thierry André, Frédéric Bibeau, Thierry Conroy, Jean-Louis Legoux, Guillaume Portier, Jean-François Bosset, Guillaume Cadiot, Olivier Bouché, Laurent Bedenne
INTRODUCTION: This document is a summary of the French Intergroup guidelines regarding the management of rectal adenocarcinoma published in February 2016. METHOD: This collaborative work, under the auspices of most of the French medical societies involved in the management of rectal cancer, is based on the previous guidelines published in 2013. Recommendations are graded into 3 categories according to the level of evidence of data found in the literature. RESULTS: In agreement with the ESMO guidelines (2013), non-metastatic rectal cancers have been stratified in 4 risk groups according to endoscopy, MRI or endorectal-ultrasonography...
April 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28177989/accuracy-of-mri-in-restaging-locally-advanced-rectal-cancer-after-preoperative-chemoradiation
#19
Joris J van den Broek, Floor S W van der Wolf, Max J Lahaye, Luc A Heijnen, Christof Meischl, Martin A Heitbrink, W Hermien Schreurs
BACKGROUND: Patients with a locally advanced rectal carcinoma benefit from preoperative chemoradiotherapy. MRI is considered the first choice imaging modality after preoperative chemoradiation, although its reliability for restaging is debatable. OBJECTIVE: The purpose of this study was to determine the accuracy of MRI in restaging locally advanced rectal cancer after preoperative chemoradiation. DESIGN: This was a retrospective study. SETTINGS: The study was conducted in a Dutch high-volume rectal cancer center...
March 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28149883/focusing-the-management-of-rectal-cancer
#20
COMMENT
Rachel Dbeis, Neil J Smart, Ian R Daniels
Rectal cancer treatment has undergone major changes over the last 15 years with a focus on individualized care based around MRI assessment of the relationship of the tumour to the mesorectal fascia, improved surgical techniques and targeted use of pre-operative oncological therapies in patients with locally advanced disease. The recognition that some tumours responded completely to pre-operative chemoradiotherapy, and the selective use of a non-operative policy has led to a quest to further identify those patients and their tumour in whom this approach could be used, irrespective of MRI stage...
December 2016: Annals of Translational Medicine
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