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MRI in local advanced rectal

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https://www.readbyqxmd.com/read/28304150/additional-chemotherapy-and-salvage-surgery-for-poor-response-to-chemoradiotherapy-in-rectal-cancers
#1
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...
March 17, 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
#2
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
#3
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...
January 20, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28177989/accuracy-of-mri-in-restaging-locally-advanced-rectal-cancer-after-preoperative-chemoradiation
#4
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
#5
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
https://www.readbyqxmd.com/read/28055248/review-article-functional-mri-for-quantitative-treatment-response-prediction-in-locally-advanced-rectal-cancer
#6
Trang T Pham, Gary P Liney, Karen Wong, Michael B Barton
Despite advances in multi-modality treatment strategies for locally advanced rectal cancer and improvements in loco-regional control, there is still a considerable variation in response to neo-adjuvant chemo-radiotherapy (CRT). Accurate prediction of response to neo-adjuvant CRT would enable early stratification of management according to good responders and poor responders, in order to adapt treatment to improve therapeutic outcomes in rectal cancer. Clinical studies in diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) MRI have shown promising results for the prediction of therapeutic response in rectal cancer...
January 5, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28042958/standardized-index-of-shape-dce-mri-and-standardized-uptake-value-pet-ct-two-quantitative-approaches-to-discriminate-chemo-radiotherapy-locally-advanced-rectal-cancer-responders-under-a-functional-profile
#7
Antonella Petrillo, Roberta Fusco, Mario Petrillo, Vincenza Granata, Paolo Delrio, Francesco Bianco, Biagio Pecori, Gerardo Botti, Fabiana Tatangelo, Corradina Caracò, Luigi Aloj, Antonio Avallone, Secondo Lastoria
PURPOSE: To investigate dynamic contrast enhanced-MRI (DCE-MRI) in the preoperative chemo-radiotherapy (CRT) assessment for locally advanced rectal cancer (LARC) compared to18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). METHODS: 75 consecutive patients with LARC were enrolled in a prospective study. DCE-MRI analysis was performed measuring SIS: linear combination of percentage change (Δ) of maximum signal difference (MSD) and wash-out slope (WOS)...
January 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/28002822/the-vegfr-inhibitor-cediranib-improves-the-efficacy-of-fractionated-radiotherapy-in-a-colorectal-cancer-xenograft-model
#8
Elodie Melsens, Bert Verberckmoes, Natacha Rosseel, Christian Vanhove, Benedicte Descamps, Piet Pattyn, Wim Ceelen
BACKGROUND/PURPOSE: Radiotherapy (RT) increases local tumor control in locally advanced rectal cancer, but complete histological response is seen in only a minority of cases. Antiangiogenic therapy has been proposed to improve RT efficacy by "normalizing" the tumor microvasculature. Here, we examined whether cediranib, a pan-vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitor, improves microvascular function and tumor control in combination with RT in a mouse colorectal cancer (CRC) model...
December 22, 2016: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/27981667/assessment-of-pathological-complete-response-to-preoperative-chemoradiotherapy-by-means-of-multiple-mathematical-models-of-diffusion-weighted-mri-in-locally-advanced-rectal-cancer-a-prospective-single-center-study
#9
Hai-Bin Zhu, Xiao-Yan Zhang, Xiao-Hong Zhou, Xiao-Ting Li, Yu-Liang Liu, Shuai Wang, Ying-Shi Sun
PURPOSE: To assess stretched-exponential, mono-exponential and intravoxel incoherent motion (IVIM) models of diffusion-weighted MRI(DWI) in predicting pathological complete response (pCR) to neoadjuvant chemoradiotherapy (CRT) in rectal cancer patients. MATERIALS AND METHODS: This prospective study recruited 98 consecutive patients with locally advanced rectal cancer who underwent 3 Tesla MR examination before, during and after CRT. The apparent diffusion coefficient (ADC), IVIM-derived parameters (D, f, and D*), and stretched-exponential model-derived parameters (DDC and α) were measured...
December 16, 2016: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/27895682/development-and-clinical-implementation-of-a-new-template-for-mri-based-intracavitary-interstitial-gynecologic-brachytherapy-for-locally-advanced-cervical-cancer-from-ct-based-mupit-to-the-mri-compatible-template-benidorm-ten-years-of-experience
#10
Silvia Rodríguez Villalba, Jose Richart Sancho, Antonio Otal Palacín, Jose Perez-Calatayud, Manuel Santos Ortega
PURPOSE: To study outcome and toxicity in 59 patients with locally advanced cervix carcinoma treated with computed tomography (CT)-based Martinez universal perineal interstitial template (MUPIT) and the new magnetic resonance imaging (MRI)-compatible template Benidorm (TB). MATERIAL AND METHODS: From December 2005 to October 2015, we retrospectively analyzed 34 patients treated with MUPIT and 25 treated with the TB. Six 4 Gy fractions were prescribed to the clinical target volume (CTV) combined with external beam radiotherapy (EBRT)...
October 2016: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/27872117/protocol-for-a-multicentre-randomised-feasibility-trial-evaluating-early-surgery-alone-in-low-rectal-cancer-sailor
#11
Dean A Harris, Kymberley Thorne, Hayley Hutchings, Saiful Islam, Gail Holland, Olivia Hatcher, Sarah Gwynne, Ian Jenkins, Peter Coyne, Michael Duff, Melanie Feldman, Des C Winter, Simon Gollins, Phil Quirke, Nick West, Gina Brown, Deborah Fitzsimmons, Alan Brown, John Beynon
INTRODUCTION: There are 11 500 rectal cancers diagnosed annually in the UK. Although surgery remains the primary treatment, there is evidence that preoperative radiotherapy (RT) improves local recurrence rates. High-quality surgery in rectal cancer is equally important in minimising local recurrence. Advances in MRI-guided prediction of resection margin status and improvements in abdominoperineal excision of the rectum (APER) technique supports a reassessment of the contribution of preoperative RT...
November 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27845566/the-potential-predictive-value-of-mri-and-pet-ct-in-mucinous-and-nonmucinous-rectal-cancer-to-identify-patients-at-high-risk-of-metastatic-disease
#12
COMPARATIVE STUDY
Brunella Barbaro, Lucia Leccisotti, Fabio M Vecchio, Marialuisa Di Matteo, Teresa Serra, Marco Salsano, Andrea Poscia, Claudio Coco, Roberto Persiani, Sergio Alfieri, Maria Antonietta Gambacorta, Vincenzo Valentini, Alessandro Giordano, Lorenzo Bonomo
OBJECTIVE: To correlate imaging parameters from baseline MRI diffusion-weighted imaging (DWI) and fludeoxyglucose (FDG) positron emission tomography (PET)-CT with synchronous and metachronous metastases in mucinous carcinoma (MC) and non-mucinous carcinoma (NMC) rectal cancer. METHODS: 111 patients with extraperitoneal locally advanced rectal cancer, who underwent pelvic MRI, DWI and FDG PET-CT, were stratified into MC (n = 23) and NMC (n = 88). We correlated adverse morphologic features on MRI [mT4, mesorectal fascia involvement, extramural venous invasion (mEMVI), mN2] and quantitative imaging parameters [minimum apparent diffusion coefficient (ADCmin), maximum standardized uptake value, total lesion glycolysis, metabolic tumour volume, T2 weighted and DWI tumour volumes] with the presence of metastatic disease...
January 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/27819636/the-importance-of-preoperative-staging-of-rectal-cancer-using-multiparametric-mri-a-systematic-review
#13
REVIEW
Ferdinand Bauer
A correct preoperative stadialization of rectal carcinoma has a direct influence upon its therapeutic strategy, resulting in a significant improvement of the survival rate and life quality after the treatment. The therapeutic strategy refers to the option of undergoing or not preoperative radiochemotherapy before the total mesorectal excision (TME). The technical advances in the magnetic resonance domain makes possible the multiparametric examinations (mp MRI) with medical equipments (3T models are common) good enough to obtain images having an excellent quality, which allow a correct diagnosis of the local tumour spread...
2016: Chirurgia
https://www.readbyqxmd.com/read/27816539/feasibility-study-of-toxicity-outcomes-using-gec-estro-contouring-guidelines-on-ct-based-instead-of-mri-based-planning-in-locally-advanced-cervical-cancer-patients
#14
Vicky Koh, Bok Ai Choo, Khai Mun Lee, Teng Hwee Tan, Jen Hui Jeffrey Low, Soon Yau Joseph Ng, Arunachalam Ilancheran, Liang Shen, Johann Tang
PURPOSE: To report late rectal and bladder toxicity outcomes of a CT-based image-guided brachytherapy (IGBT) technique for treatment of cervical cancer. METHODS AND MATERIALS: Between 2008 and 2014, 95 women with International Federation of Gynecology and Obstetrics stage IB to IVA cervical carcinoma treated with definitive concurrent cisplatin-based chemotherapy and external beam radiation therapy 50.4 Gy in 28 fractions followed by planned prescription dose of 7 Gy × 4 fractions of high-dose-rate IGBT was retrospectively reviewed...
January 2017: Brachytherapy
https://www.readbyqxmd.com/read/27743742/capecitabine-and-oxaliplatin-before-during-and-after-radiotherapy-for-high-risk-rectal-cancer
#15
Finn Ole Larsen, Alice Markussen, Benny V Jensen, Anne L Fromm, Kirsten K Vistisen, Vibeke K Parner, Dorte Linnemann, Rasmus H Hansen, Helle H Johannesen, Jakob V Schou
PURPOSE: To evaluate the effect of capecitabine and oxaliplatin before, during, and after radiotherapy for high-risk rectal cancer. PATIENTS AND METHODS: Patients with rectum cancer T4 or T3 involving the mesorectal fascia was included in a prospective phase 2 trial. Liver or lung metastases were accepted if the surgeons found them resectable. The patients received 6 weeks of capecitabine and oxaliplatin before chemoradiotherapy (CRT), continued capecitabine and oxaliplatin during radiotherapy, and received 4 weeks of capecitabine and oxaliplatin after CRT...
September 14, 2016: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/27698520/re-staging-following-long-course-chemoradiotherapy-for-rectal-cancer-does-it-influence-management
#16
A McBrearty, K McCallion, R J Moorehead, I McAllister, K Mulholland, R Gilliland, W J Campbell
BACKGROUND: In patients with locally advanced or low rectal cancers, long-course chemoradiotherapy (LCCRT) is recommended prior to surgical management.(1) The need for restaging afterwards has been questioned as it may be difficult to interpret imaging due to local tissue effects of chemoradiotherapy. The purpose of this study was to determine if restaging affected the management of patients receiving long-course chemoradiotherapy for rectal cancer. METHODS: A retrospective review of patients with rectal cancer discussed at the South Eastern Health and Social Care Trust Lower Gastrointestinal Multi-Disciplinary Team Meeting (LGIMDT) in 2013 who had received long-course chemoradiotherapy was performed...
September 2016: Ulster Medical Journal
https://www.readbyqxmd.com/read/27697137/cancer-of-the-upper-rectum
#17
REVIEW
Peter Bondeven
Rectal cancer constitutes one-third of all colorectal cancers, and the incidence in Denmark increasing. In 2012, 1.400 cases were registered, and of these 38% were located in the upper rectum. There have been several key advances in the optimal management of rectal cancer during the past decades, primarily by standardisation and improvement of the surgical procedure. There is now general agreement that the optimal surgical treatment involves the concept of total mesorectal excision and that a resection with tumour-free margins is crucial...
October 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27673438/adjuvant-chemotherapy-may-improve-disease-free-survival-in-patients-with-mremvi-positive-rectal-cancer-following-chemoradiation
#18
Manish Chand, Shahnawaz Rasheed, Richard Heald, Ian Swift, Nick West, Sheela Rao, Paris Tekkis, Gina Brown
AIM: MRI-detected extramural venous invasion (mrEMVI) is a poor prognostic factor in rectal cancer. Pre-operative chemoradiotherapy (CRT) can cause regression in the severity of EMVI and subsequently improve survival whereas mrEMVI persisting after CRT confers an increased risk of recurrence. The effect of adjuvant chemotherapy (AC) following CRT on survival in rectal cancer remains unclear. The aim of this study was to determine whether there is a survival advantage for AC given to patients with mrEMVI persisting after CRT...
September 27, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27670762/a-comparison-of-fitting-algorithms-for-diffusion-weighted-mri-data-analysis-using-an-intravoxel-incoherent-motion-model
#19
Roberta Fusco, Mario Sansone, Antonella Petrillo
OBJECT: The objective of this study is to propose a modified VARiable PROjection (VARPRO) algorithm specifically tailored for fitting the intravoxel incoherent motion (IVIM) model to diffusion-weighted magnetic resonance imaging (DW-MRI) data from locally advanced rectal cancer (LARC). MATERIALS AND METHODS: The proposed algorithm is compared with classical non-linear least squares (NLLS) analysis using the Levenberg-Marquardt (LM) algorithm and with two recently proposed algorithms for 'segmented' analysis...
September 26, 2016: Magma
https://www.readbyqxmd.com/read/27631106/the-value-of-diffusion-kurtosis-magnetic-resonance-imaging-for-assessing-treatment-response-of-neoadjuvant-chemoradiotherapy-in-locally-advanced-rectal-cancer
#20
Jing Yu, Qing Xu, Jia-Cheng Song, Yan Li, Xin Dai, Dong-Ya Huang, Ling Zhang, Yang Li, Hai-Bin Shi
OBJECTIVES: To evaluate the feasibility and value of diffusion kurtosis (DK) imaging in assessing treatment response to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC). METHODS: Forty-one patients were included. All patients underwent pre- and post-CRT DCE-MRI on a 3.0-Tesla MRI scanner. Imaging indices (D app , K app and ADC values) were measured. Change value (∆X) and change ratio (r∆X) were calculated. Pathological tumour regression grade scores (Mandard) were the standard reference (good responders: pTRG 1-2; poor responders: pTRG 3-5)...
September 8, 2016: European Radiology
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