Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI : a multicenter and multireader study
© 2023. The Author(s)..
PURPOSE: Pre-treatment knowledge of the anticipated response of rectal tumors to neoadjuvant chemoradiotherapy (CRT) could help to further optimize the treatment. Van Griethuysen et al. proposed a visual 5-point confidence score to predict the likelihood of response on baseline MRI. Aim was to evaluate this score in a multicenter and multireader study setting and compare it to two simplified (4-point and 2-point) adaptations in terms of diagnostic performance, interobserver agreement (IOA), and reader preference.
METHODS: Twenty-two radiologists from 14 countries (5 MRI-experts,17 general/abdominal radiologists) retrospectively reviewed 90 baseline MRIs to estimate if patients would likely achieve a (near-)complete response (nCR); first using the 5-point score by van Griethuysen (1=highly unlikely to 5=highly likely to achieve nCR), second using a 4-point adaptation (with 1-point each for high-risk T-stage, obvious mesorectal fascia invasion, nodal involvement, and extramural vascular invasion), and third using a 2-point score (unlikely/likely to achieve nCR). Diagnostic performance was calculated using ROC curves and IOA using Krippendorf's alpha (α).
RESULTS: Areas under the ROC curve to predict the likelihood of a nCR were similar for the three methods (0.71-0.74). IOA was higher for the 5- and 4-point scores (α=0.55 and 0.57 versus 0.46 for the 2-point score) with best results for the MRI-experts (α=0.64-0.65). Most readers (55%) favored the 4-point score.
CONCLUSIONS: Visual morphologic assessment and staging methods can predict neoadjuvant treatment response with moderate-good performance. Compared to a previously published confidence-based scoring system, study readers preferred a simplified 4-point risk score based on high-risk T-stage, MRF involvement, nodal involvement, and EMVI.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
Abdominal radiology (New York) - 48(2023), 10 vom: 05. Okt., Seite 3039-3049 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
El Khababi, Najim [VerfasserIn] |
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| Links: |
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| Themen: |
Chemoradiotherapy |
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| Anmerkungen: |
Date Completed 07.09.2023 Date Revised 03.10.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00261-023-03961-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM358599571 |
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| 100 | 1 | |a El Khababi, Najim |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI |b a multicenter and multireader study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 07.09.2023 | ||
| 500 | |a Date Revised 03.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a PURPOSE: Pre-treatment knowledge of the anticipated response of rectal tumors to neoadjuvant chemoradiotherapy (CRT) could help to further optimize the treatment. Van Griethuysen et al. proposed a visual 5-point confidence score to predict the likelihood of response on baseline MRI. Aim was to evaluate this score in a multicenter and multireader study setting and compare it to two simplified (4-point and 2-point) adaptations in terms of diagnostic performance, interobserver agreement (IOA), and reader preference | ||
| 520 | |a METHODS: Twenty-two radiologists from 14 countries (5 MRI-experts,17 general/abdominal radiologists) retrospectively reviewed 90 baseline MRIs to estimate if patients would likely achieve a (near-)complete response (nCR); first using the 5-point score by van Griethuysen (1=highly unlikely to 5=highly likely to achieve nCR), second using a 4-point adaptation (with 1-point each for high-risk T-stage, obvious mesorectal fascia invasion, nodal involvement, and extramural vascular invasion), and third using a 2-point score (unlikely/likely to achieve nCR). Diagnostic performance was calculated using ROC curves and IOA using Krippendorf's alpha (α) | ||
| 520 | |a RESULTS: Areas under the ROC curve to predict the likelihood of a nCR were similar for the three methods (0.71-0.74). IOA was higher for the 5- and 4-point scores (α=0.55 and 0.57 versus 0.46 for the 2-point score) with best results for the MRI-experts (α=0.64-0.65). Most readers (55%) favored the 4-point score | ||
| 520 | |a CONCLUSIONS: Visual morphologic assessment and staging methods can predict neoadjuvant treatment response with moderate-good performance. Compared to a previously published confidence-based scoring system, study readers preferred a simplified 4-point risk score based on high-risk T-stage, MRF involvement, nodal involvement, and EMVI | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Chemoradiotherapy | |
| 650 | 4 | |a Magnetic resonance imaging | |
| 650 | 4 | |a Rectal cancer | |
| 650 | 4 | |a Response | |
| 700 | 1 | |a Beets-Tan, Regina G H |e verfasserin |4 aut | |
| 700 | 1 | |a Tissier, Renaud |e verfasserin |4 aut | |
| 700 | 1 | |a Lahaye, Max J |e verfasserin |4 aut | |
| 700 | 1 | |a Maas, Monique |e verfasserin |4 aut | |
| 700 | 1 | |a Curvo-Semedo, Luís |e verfasserin |4 aut | |
| 700 | 1 | |a Dresen, Raphaëla C |e verfasserin |4 aut | |
| 700 | 1 | |a Nougaret, Stephanie |e verfasserin |4 aut | |
| 700 | 1 | |a Beets, Geerard L |e verfasserin |4 aut | |
| 700 | 1 | |a Lambregts, Doenja M J |e verfasserin |4 aut | |
| 700 | 0 | |a rectal MRI study group |e verfasserin |4 aut | |
| 700 | 1 | |a Bakers, Frans C H |e investigator |4 oth | |
| 700 | 1 | |a Barros, Perla |e investigator |4 oth | |
| 700 | 1 | |a Bauer, Ferdinand |e investigator |4 oth | |
| 700 | 1 | |a de Bie, Shira H |e investigator |4 oth | |
| 700 | 1 | |a Ballantyne, Stuart |e investigator |4 oth | |
| 700 | 1 | |a Dutra, Joanna Brayner |e investigator |4 oth | |
| 700 | 1 | |a Buskov, Laura |e investigator |4 oth | |
| 700 | 1 | |a Bogveradze, Nino |e investigator |4 oth | |
| 700 | 1 | |a Bosma, Gerlof P T |e investigator |4 oth | |
| 700 | 1 | |a Cappendijk, Vincent C |e investigator |4 oth | |
| 700 | 1 | |a Castagnoli, Francesca |e investigator |4 oth | |
| 700 | 1 | |a Charalampos, Sotiriadis |e investigator |4 oth | |
| 700 | 1 | |a Delli Pizzi, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Digby, Michael |e investigator |4 oth | |
| 700 | 1 | |a Geenen, Remy W F |e investigator |4 oth | |
| 700 | 1 | |a van Griethuysen, Joost J M |e investigator |4 oth | |
| 700 | 1 | |a Lafrance, Julie |e investigator |4 oth | |
| 700 | 1 | |a Mahajan, Vandana |e investigator |4 oth | |
| 700 | 1 | |a Malekzadeh, Sonaz |e investigator |4 oth | |
| 700 | 1 | |a Neijenhuis, Peter A |e investigator |4 oth | |
| 700 | 1 | |a Peterson, Gerald M |e investigator |4 oth | |
| 700 | 1 | |a Pieters, Indra |e investigator |4 oth | |
| 700 | 1 | |a Schurink, Niels W |e investigator |4 oth | |
| 700 | 1 | |a Smit, Ruth |e investigator |4 oth | |
| 700 | 1 | |a Veeken, Cornelis J |e investigator |4 oth | |
| 700 | 1 | |a Vliegen, Roy F A |e investigator |4 oth | |
| 700 | 1 | |a Wray, Andrew |e investigator |4 oth | |
| 700 | 1 | |a Zeina, Abdel-Rauf |e investigator |4 oth | |
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