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Value of diffusion‐weighted and gadolinium‐enhanced MRI for the diagnosis of pelvic recurrence from colorectal cancer

2013; Wiley; Volume: 40; Issue: 2 Linguagem: Inglês

10.1002/jmri.24366

1522-2586

Alban Colosio, Philippe Soyer, Pascal Rousset, Coralie Barbe, F. Nguyen, Olivier Bouché, Christine Hoeffel,

Diverticular Disease and Complications

To prospectively assess the added value of gadolinium-enhanced and diffusion-weighted (DWI) MRI for the diagnosis of pelvic recurrence from colorectal cancer (CRC).Fifty-two patients with suspected pelvic recurrence from CRC underwent pelvic MRI with T2-weighted ("T2"), gadolinium-enhanced fat-suppressed T1-weighted ("gadolinium") and DWI MR sequences. Three readers (senior radiologist: R1, two residents: R2, R3) scored the likelihood of recurrence on "T2," "T2 + DWI," and "T2 + Gadolinium."Twenty-seven patients had 42 sites of pelvic recurrence. On "T2," R1 achieved AUC of .95, sensitivity 88.4%, specificity 95.2%. For R2, these figures were .89, 81.4%, 90.5%, for R3 .90, 83.7%, 76%. Both Gadolinium injection and DWI significantly improved AUCs for residents but not for the senior radiologist: up to .988 (R2, P = 0.006) and to .98 (R3, P = 0.01) with DWI and to .96 (R2, P = 0.04), .98 (R3, P = 0.01) after gadolinium. All readers achieved slightly better AUCs with "T2 + DWI" than with "T2+Gadolinium" but not significantly (P = 0.68, P = 0.11, P = 0.3; respectively).For diagnosis of pelvic recurrence from CRC, both DWI and gadolinium-enhanced MRI significantly increase diagnostic performances compared with "T2" MRI for residents. DWI may be helpful in patients with contra-indications to intravenous administration of gadolinium.