caa a22 4500 445336404 CHVBK 20180317142757.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1245/s10434-011-1607-5 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1607-5 Diffusion-Weighted MRI for Selection of Complete Responders After Chemoradiation for Locally Advanced Rectal Cancer: A Multicenter Study [Elektronische Daten] [Doenja Lambregts, Vincent Vandecaveye, Brunella Barbaro, Frans Bakers, Maarten Lambrecht, Monique Maas, Karin Haustermans, Vincenzo Valentini, Geerard Beets, Regina Beets-Tan] Purpose: In 10-24% of patients with rectal cancer who are treated with neoadjuvant chemoradiation, no residual tumor is found after surgery (ypT0). When accurately selected, these complete responders might be considered for less invasive treatments instead of standard surgery. So far, no imaging method has proven reliable. This study was designed to assess the accuracy of diffusion-weighted MRI (DWI) in addition to standard rectal MRI for selection of complete responders after chemoradiation. Methods: A total of 120 patients with locally advanced rectal cancer from three university hospitals underwent chemoradiation followed by a restaging MRI (1.5T), consisting of standard T2W-MRI and DWI (b0-1000). Three independent readers first scored the standard MRI only for the likelihood of a complete response using a 5-point confidence score, after which the DWI images were added and the scoring was repeated. Histology (ypT0 vs. ypT1-4) was the standard reference. Diagnostic performance for selection of complete responders and interobserver agreement were compared for the two readings. Results: Twenty-five of 120 patients had a complete response (ypT0). Areas under the ROC-curve for the three readers improved from 0.76, 0.68, and 0.58, using only standard MRI, to 0.8, 0.8, and 0.78 after addition of DWI (P=0.39, 0.02, and 0.002). Sensitivity for selection of complete responders ranged from 0-40% on standard MRI versus 52-64% after addition of DWI. Specificity was equally high (89-98%) for both reading sessions. Interobserver agreement improved from κ 0.2-0.32 on standard MRI to 0.51-0.55 after addition of DWI. Conclusions: Addition of DWI to standard rectal MRI improves the selection of complete responders after chemoradiation. The Author(s), 2011 Lambregts Doenja Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands aut Vandecaveye Vincent Department of Radiology, University Hospitals Leuven, Leuven, Belgium aut Barbaro Brunella Department of Radiology, Università Cattolica del Sacro Cuore, Rome, Italy aut Bakers Frans Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands aut Lambrecht Maarten Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium aut Maas Monique Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands aut Haustermans Karin Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium aut Valentini Vincenzo Department of Radiation Oncology, Università Cattolica del Sacro Cuore, Rome, Italy aut Beets Geerard Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands aut Beets-Tan Regina Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands aut Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2224-2231 1068-9265 18:8<2224 2011 18 10434 https://doi.org/10.1245/s10434-011-1607-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1607-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lambregts Doenja Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Vandecaveye Vincent Department of Radiology, University Hospitals Leuven, Leuven, Belgium aut NATIONALLICENCE 700 1- Barbaro Brunella Department of Radiology, Università Cattolica del Sacro Cuore, Rome, Italy aut NATIONALLICENCE 700 1- Bakers Frans Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Lambrecht Maarten Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium aut NATIONALLICENCE 700 1- Maas Monique Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Haustermans Karin Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium aut NATIONALLICENCE 700 1- Valentini Vincenzo Department of Radiation Oncology, Università Cattolica del Sacro Cuore, Rome, Italy aut NATIONALLICENCE 700 1- Beets Geerard Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Beets-Tan Regina Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2224-2231 1068-9265 18:8<2224 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer