title: Prognostic aspects of DCE-MRI in recurrent rectal cancer.
abstract: OBJECTIVE
  To explore whether pre-reoperative dynamic contrast-enhanced (DCE)-MRI findings correlate with clinical outcome in patients who undergo surgical treatment for recurrent rectal carcinoma.
  
  
  METHODS
  A retrospective study of DCE-MRI in patients with recurrent rectal cancer was performed after obtaining an IRB waiver. We queried our PACS from 1998 to 2012 for examinations performed for recurrent disease. Two radiologists in consensus outlined tumour regions of interest on perfusion images. We explored the correlation between K(trans), Kep, Ve, AUC90 and AUC180 with time to re-recurrence of tumour, overall survival and resection margin status. Univariate Cox PH models were used for survival, while univariate logistic regression was used for margin status.
  
  
  RESULTS
  Among 58 patients with pre-treatment DCE-MRI who underwent resection, 36 went directly to surgery and 18 had positive margins. K(trans) (0.55, P = 0.012) and Kep (0.93, P = 0.04) were inversely correlated with positive margins. No significant correlations were noted between K(trans), Kep, Ve, AUC90 and AUC180 and overall survival or time to re-recurrence of tumour.
  
  
  CONCLUSIONS
  K(trans) and Kep were significantly associated with clear resection margins; however overall survival and time to re-recurrence were not predicted. Such information might be helpful for treatment individualisation and deserves further investigation.
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA, gollubm@mskcc.org.
authors: M J
authors: MJ
authors: Gollub
authors: K
authors: K
authors: Cao
authors: D H
authors: DH
authors: Gultekin
authors: D
authors: D
authors: Kuk
authors: M
authors: M
authors: Gonen
authors: M
authors: M
authors: Sohn
authors: L H
authors: LH
authors: Schwartz
authors: M R
authors: MR
authors: Weiser
authors: L K
authors: LK
authors: Temple
authors: G M
authors: GM
authors: Nash
authors: J G
authors: JG
authors: Guillem
authors: M
authors: M
authors: Wang
authors: J
authors: J
authors: Garcia-Aguilar
authors: K
authors: K
authors: Goodman
authors: P B
authors: PB
authors: Paty
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
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