Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study
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Published:2023-06-26
Issue:10
Volume:48
Page:3039-3049
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ISSN:2366-0058
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Container-title:Abdominal Radiology
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language:en
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Short-container-title:Abdom Radiol
Author:
El Khababi Najim, Beets-Tan Regina G. H., Tissier Renaud, Lahaye Max J., Maas Monique, Curvo-Semedo Luís, Dresen Raphaëla C., Nougaret Stephanie, Beets Geerard L., Lambregts Doenja M. J.ORCID, Bakers Frans C. H., Barros Perla, Bauer Ferdinand, de Bie Shira H, Ballantyne Stuart, Dutra Joanna Brayner, Buskov Laura, Bogveradze Nino, Bosma Gerlof P. T., Cappendijk Vincent C, Castagnoli Francesca, Charalampos Sotiriadis, Delli Pizzi Andrea, Digby Michael, Geenen Remy W. F., van Griethuysen Joost J. M., Lafrance Julie, Mahajan Vandana, Malekzadeh Sonaz, Neijenhuis Peter A, Peterson Gerald M, Pieters Indra, Schurink Niels W., Smit Ruth, Veeken Cornelis J., Vliegen Roy F. A., Wray Andrew, Zeina Abdel-Rauf,
Abstract
Abstract
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.
Graphical abstract
Funder
KWF Kankerbestrijding
Publisher
Springer Science and Business Media LLC
Subject
Urology,Gastroenterology,Radiology, Nuclear Medicine and imaging,Radiological and Ultrasound Technology
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