MRI Predicts Residual Disease and Outcomes in Watch-and-Wait Patients with Rectal Cancer

医学 结直肠癌 残余物 疾病 放射科 癌症 内科学 算法 计算机科学
作者
Hannah Williams,Dana M. Omer,H Thompson,Sabrina T. Lin,Floris S. Verheij,João Miranda,Jonathan B. Yuval,James G. Buckley,Michael R. Marco,Li‐Xuan Qin,David Dombroski,R P Kedar,Aytekin Oto,Elena Korngold,Joseph C. Veniero,Sunil Gandhi,Arun Krishnaraj,Minal Jagtiani Sangwaiya,Kirk Ohanian,Dan Vu
出处
期刊:Radiology [Radiological Society of North America]
卷期号:312 (3) 被引量:4
标识
DOI:10.1148/radiol.232748
摘要

Background MRI plays a crucial role in restaging locally advanced rectal cancer treated with total neoadjuvant therapy (TNT); however, prospective studies have not evaluated its ability to accurately select patients for nonoperative management. Purpose To evaluate the ability of restaging MRI to predict oncologic outcomes and identify imaging features associated with residual disease (RD) after TNT. Materials and Methods This was a secondary analysis of the Organ Preservation in Rectal Adenocarcinoma (OPRA) trial, which randomized participants from April 2014 to March 2020 with stages II or III rectal adenocarcinoma to undergo either induction or consolidation TNT. Participants enrolled in the OPRA trial who underwent restaging MRI were eligible for inclusion in the present study. Radiologists classified participants as having clinical complete response (cCR), near-complete clinical response (nCR), or incomplete clinical response (iCR) based on restaging MRI at a mean of 8 weeks ± 4 (SD) after treatment. Oncologic outcomes according to MRI response category were assessed using Kaplan-Meier curves. Logistic regression analysis was performed to identify imaging characteristics associated with RD. Results A total of 277 participants (median age, 58 years [IQR, 17 years]; 179 male) who were randomized in the OPRA trial had restaging MRI forms completed. The median follow-up duration was 4.1 years. Participants with cCR had higher rates of organ preservation compared with those with nCR (65.3% vs 41.6%, log-rank
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