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Congress: ECR24
Poster Number: C-12456
Type: EPOS Radiologist (scientific)
Authorblock: Q-Y. Li, X. Zhang, D. Yang, Z. Guan, X-Y. Yan, L. X. Ting, R-J. Sun, Q. Lu, Y-S. Sun; Beijing/CN
Disclosures:
Qing-Yang Li: Nothing to disclose
Xiaoyan Zhang: Nothing to disclose
Ding Yang: Nothing to disclose
Zhen Guan: Nothing to disclose
Xin-Yue Yan: Nothing to disclose
Li Xiao Ting: Nothing to disclose
Rui-Jia Sun: Nothing to disclose
Qiaoyuan Lu: Nothing to disclose
Ying-Shi Sun: Nothing to disclose
Keywords: Gastrointestinal tract, Lymph nodes, Oncology, MR, Diagnostic procedure, Staging, Cancer, Metastases
Purpose     Radiological evaluation has been positioned as vital in clinical management since the treatment of rectal cancer has evolved rapidly and has now entered the era of individualization [1], while the regional nodal status, which is of great prognostic importance, has been omitted in most studies.    Extranodal extension (ENE) refers to the extension of tumor cells from metastatic lymph nodes into perinodal fatty tissue through the thin fibrous capsule that envelops the entire lymph node on histopathology. With...
Read more Methods and materials Study sample     This two-stage single-center study included a prospective development dataset consisting of consecutive participants with rectal cancer who underwent pretreatment MRI and direct total mesorectal excision (TME) from December 2021 to January 2023 and a retrospective validation cohort of consecutive patients with locally advanced rectal cancer who had available pretreatment MRI and underwent TME after neoadjuvant therapy (NAT) from December 2019 to July 2020. Informed consent was obtained from participants in the development dataset and the requirement for...
Read more Results     In total, 147 participants were included of which 37 (25%) had pathologically confirmed ENE+ nodes. [fig 5] Among the total of 1008 nodes with a short-axis diameter ≥ 3 mm identified on MRI of the 147 participants, 336 nodes that failed to achieve node-by-node matching (n=275) or located beyond the scan range of any evaluated sequences (n=61) were excluded, resulting in the inclusion of 672 nodes in the development dataset. According to the postoperative pathological results, the pathologic-ENE- and...
Read more Conclusion     In our development dataset, the inclusion of participants who underwent direct surgery and the establishment of 3D node maps based on localization on MRI ensured the direct and precise node-by-node matching between MRI and pathology, thus providing a more reliable reference for the nodal radiological evaluation.    The broken-ring and tail sign were derived from the CSE [8, 9], which was proposed to identify carcinoma within the node previously, and the “flare” sign, which was an important diagnostic...
Read more References Keller DS, Berho M, Perez RO, Wexner SD, Chand M. The multidisciplinary management of rectal cancer. Nat Rev Gastroenterol Hepatol 2020;17(7):414-429. doi: 10.1038/s41575-020-0275-y Arrichiello G, Pirozzi M, Facchini BA, Facchini S, Paragliola F, Nacca V, Nicastro A, Canciello MA, Orlando A, Caterino M, Ciardiello D, Della Corte CM, Fasano M, Napolitano S, Troiani T, Ciardiello F, Martini G, Martinelli E. Beyond N staging in colorectal cancer: Current approaches and future perspectives. Front Oncol 2022;12:937114. doi: 10.3389/fonc.2022.937114 Veronese N, Nottegar A, Pea A,...
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