Murshid, K.J. (Kawthar) (2018) The Use of Diffusion-Weighted MRI in The Differentiation Between Recurrent Rectal Cancer and Fibrosis. thesis, Medicine.
Full text available on request.Abstract
Objective To assess the value of diffusion-weighted magnetic resonance imaging (DW-MRI) in the discrimination between viable tumor tissue and fibrosis/inflammation in rectal cancer patients who present with an FDG-avid presacral mass during follow-up after primary rectal cancer treatment. Materials and Methods Retrospective study design, which includes 38 patients who completed primary treatment for rectal cancer and presented with an FDG-avid presacral mass on PET/CT, suspicious for locally recurrent disease. Twenty-seven patients also underwent MRI, of whom 24 with DWI. PPV of FDG-PET/CT and value of MRI and DWMRI were determined. MRI scans were independently evaluated by two radiologists. Results AUCs of MRI with DWI were 0.803 and 0.811, for observers 1 and 2, respectively. There were no significant differences among any of these AUCs (P=0.169 to 0.906). MRI without DWI achieved sensitivity and specificity values of 52.6% (10/19) and 100% (8/8) for observer 1, and 73.7% (14/19) and 100% (8/8) for observer 2. MRI with DWI achieved sensitivity and specificity values of 70.6% (12/17) and 100% (7/7) for observer 1, and 70.6% (12/17) and 85.7% (6/7) for observer 2. Both observers agreed that MRI without and with DWI were both moderate with weighted κ values of 0.522 and 0.528, respectively. Conclusion The use of MRI certainly plays an important role in the diagnosis of suspicious locally recurrent rectal cancer. However, DW-MRI does not necessarily have an additional value. In addition, FDG-PET/CT has proven to be an insignificant tool in diagnosing local recurrence.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Pennings, Jan P. MD and Department of Radiology, Nuclear Medicine and Molecular Imag and Imaging Center, University Medical Center Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:54 |
| Last Modified: | 25 Jun 2020 10:54 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1527 |
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