title: Computerized analysis of enhancement kinetics for preoperative lymph node staging in rectal cancer using dynamic contrast-enhanced magnetic resonance imaging.
abstract: For this feasibility study, dynamic contrast-enhanced magnetic resonance imaging (dceMRI) was performed preoperatively in 9 patients with histologically proven rectal carcinoma. A total of 41 lymph nodes detected were matched to histopathology. Their contrast enhancement patterns were evaluated using computer-aided analysis and categorized in persistent, plateau, and washout curve type. Highest diagnostic accuracy for detecting malignancy was observed, when less than 31.8% of the voxels within a lymph node demonstrated a washout curve (sensitivity/specificity of 81.8%/89.7%; area under the curve, AUC=0.87). In comparison, conventional size measurements revealed lower AUC of 0.81 (sensitivity/specificity of 75%/72.4%). We conclude that dceMRI might be of diagnostic value for preoperative lymph node staging.
authors.affiliation: Department of Radiology, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675 Munich, Germany. Electronic address: Tibor.Vag@tum.de.
authors.forename: Tibor
authors.initials: T
authors.lastname: Vag
authors.affiliation: Institute of Pathology, Klinikum Rechts der Isar, Technical University Munich, Trogerstrasse 18, 81675 Munich, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Slotta-Huspenina
authors.affiliation: Department of General Surgery, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenberg
authors.affiliation: Department of General Surgery, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Franz G
authors.initials: FG
authors.lastname: Bader
authors.affiliation: Department of General Surgery, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Nitsche
authors.affiliation: Institute of Pathology, Klinikum Rechts der Isar, Technical University Munich, Trogerstrasse 18, 81675 Munich, Germany.
authors.forename: Enken
authors.initials: E
authors.lastname: Drecoll
authors.affiliation: Department of Radiology, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Rummeny
authors.affiliation: Department of Radiology, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675 Munich, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Gaa
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000493:pharmacokinetics*; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods*; D012004:Rectal Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: CAD; Enhancement kinetics; Lymph node; MRI; Rectal cancer