Computerized analysis of enhancement kinetics for preoperative lymph node staging in rectal cancer using dynamic contrast-enhanced magnetic resonance imaging

Clin Imaging. 2014 Nov-Dec;38(6):845-9. doi: 10.1016/j.clinimag.2014.06.011. Epub 2014 Jun 19.

Abstract

For this feasibility study, dynamic contrast-enhanced magnetic resonance imaging (dceMRI) was performed preoperatively in 9 patients with histologically proven rectal carcinoma. A total of 41 lymph nodes detected were matched to histopathology. Their contrast enhancement patterns were evaluated using computer-aided analysis and categorized in persistent, plateau, and washout curve type. Highest diagnostic accuracy for detecting malignancy was observed, when less than 31.8% of the voxels within a lymph node demonstrated a washout curve (sensitivity/specificity of 81.8%/89.7%; area under the curve, AUC=0.87). In comparison, conventional size measurements revealed lower AUC of 0.81 (sensitivity/specificity of 75%/72.4%). We conclude that dceMRI might be of diagnostic value for preoperative lymph node staging.

Keywords: CAD; Enhancement kinetics; Lymph node; MRI; Rectal cancer.

MeSH terms

  • Aged
  • Contrast Media / pharmacokinetics*
  • Feasibility Studies
  • Female
  • Gadolinium DTPA / pharmacokinetics
  • Humans
  • Image Enhancement / methods
  • Image Processing, Computer-Assisted / methods*
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis / pathology
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Preoperative Care / methods*
  • Rectal Neoplasms / pathology*
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Gadolinium DTPA