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Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study

PURPOSE: Pre-treatment knowledge of the anticipated response of rectal tumors to neoadjuvant chemoradiotherapy (CRT) could help to further optimize the treatment. Van Griethuysen et al. proposed a visual 5-point confidence score to predict the likelihood of response on baseline MRI. Aim was to evalu...

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Autores principales: El Khababi, Najim, Beets-Tan, Regina G. H., Tissier, Renaud, Lahaye, Max J., Maas, Monique, Curvo-Semedo, Luís, Dresen, Raphaëla C., Nougaret, Stephanie, Beets, Geerard L., Lambregts, Doenja M. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10480283/
https://www.ncbi.nlm.nih.gov/pubmed/37358604
http://dx.doi.org/10.1007/s00261-023-03961-7
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author El Khababi, Najim
Beets-Tan, Regina G. H.
Tissier, Renaud
Lahaye, Max J.
Maas, Monique
Curvo-Semedo, Luís
Dresen, Raphaëla C.
Nougaret, Stephanie
Beets, Geerard L.
Lambregts, Doenja M. J.
author_facet El Khababi, Najim
Beets-Tan, Regina G. H.
Tissier, Renaud
Lahaye, Max J.
Maas, Monique
Curvo-Semedo, Luís
Dresen, Raphaëla C.
Nougaret, Stephanie
Beets, Geerard L.
Lambregts, Doenja M. J.
author_sort El Khababi, Najim
collection PubMed
description PURPOSE: Pre-treatment knowledge of the anticipated response of rectal tumors to neoadjuvant chemoradiotherapy (CRT) could help to further optimize the treatment. Van Griethuysen et al. proposed a visual 5-point confidence score to predict the likelihood of response on baseline MRI. Aim was to evaluate this score in a multicenter and multireader study setting and compare it to two simplified (4-point and 2-point) adaptations in terms of diagnostic performance, interobserver agreement (IOA), and reader preference. METHODS: Twenty-two radiologists from 14 countries (5 MRI-experts,17 general/abdominal radiologists) retrospectively reviewed 90 baseline MRIs to estimate if patients would likely achieve a (near-)complete response (nCR); first using the 5-point score by van Griethuysen (1=highly unlikely to 5=highly likely to achieve nCR), second using a 4-point adaptation (with 1-point each for high-risk T-stage, obvious mesorectal fascia invasion, nodal involvement, and extramural vascular invasion), and third using a 2-point score (unlikely/likely to achieve nCR). Diagnostic performance was calculated using ROC curves and IOA using Krippendorf’s alpha (α). RESULTS: Areas under the ROC curve to predict the likelihood of a nCR were similar for the three methods (0.71–0.74). IOA was higher for the 5- and 4-point scores (α=0.55 and 0.57 versus 0.46 for the 2-point score) with best results for the MRI-experts (α=0.64-0.65). Most readers (55%) favored the 4-point score. CONCLUSIONS: Visual morphologic assessment and staging methods can predict neoadjuvant treatment response with moderate–good performance. Compared to a previously published confidence-based scoring system, study readers preferred a simplified 4-point risk score based on high-risk T-stage, MRF involvement, nodal involvement, and EMVI. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00261-023-03961-7.
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spelling pubmed-104802832023-09-07 Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study El Khababi, Najim Beets-Tan, Regina G. H. Tissier, Renaud Lahaye, Max J. Maas, Monique Curvo-Semedo, Luís Dresen, Raphaëla C. Nougaret, Stephanie Beets, Geerard L. Lambregts, Doenja M. J. Abdom Radiol (NY) Hollow Organ GI PURPOSE: Pre-treatment knowledge of the anticipated response of rectal tumors to neoadjuvant chemoradiotherapy (CRT) could help to further optimize the treatment. Van Griethuysen et al. proposed a visual 5-point confidence score to predict the likelihood of response on baseline MRI. Aim was to evaluate this score in a multicenter and multireader study setting and compare it to two simplified (4-point and 2-point) adaptations in terms of diagnostic performance, interobserver agreement (IOA), and reader preference. METHODS: Twenty-two radiologists from 14 countries (5 MRI-experts,17 general/abdominal radiologists) retrospectively reviewed 90 baseline MRIs to estimate if patients would likely achieve a (near-)complete response (nCR); first using the 5-point score by van Griethuysen (1=highly unlikely to 5=highly likely to achieve nCR), second using a 4-point adaptation (with 1-point each for high-risk T-stage, obvious mesorectal fascia invasion, nodal involvement, and extramural vascular invasion), and third using a 2-point score (unlikely/likely to achieve nCR). Diagnostic performance was calculated using ROC curves and IOA using Krippendorf’s alpha (α). RESULTS: Areas under the ROC curve to predict the likelihood of a nCR were similar for the three methods (0.71–0.74). IOA was higher for the 5- and 4-point scores (α=0.55 and 0.57 versus 0.46 for the 2-point score) with best results for the MRI-experts (α=0.64-0.65). Most readers (55%) favored the 4-point score. CONCLUSIONS: Visual morphologic assessment and staging methods can predict neoadjuvant treatment response with moderate–good performance. Compared to a previously published confidence-based scoring system, study readers preferred a simplified 4-point risk score based on high-risk T-stage, MRF involvement, nodal involvement, and EMVI. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00261-023-03961-7. Springer US 2023-06-26 2023 /pmc/articles/PMC10480283/ /pubmed/37358604 http://dx.doi.org/10.1007/s00261-023-03961-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Hollow Organ GI
El Khababi, Najim
Beets-Tan, Regina G. H.
Tissier, Renaud
Lahaye, Max J.
Maas, Monique
Curvo-Semedo, Luís
Dresen, Raphaëla C.
Nougaret, Stephanie
Beets, Geerard L.
Lambregts, Doenja M. J.
Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study
title Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study
title_full Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study
title_fullStr Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study
title_full_unstemmed Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study
title_short Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI: a multicenter and multireader study
title_sort predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline mri: a multicenter and multireader study
topic Hollow Organ GI
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10480283/
https://www.ncbi.nlm.nih.gov/pubmed/37358604
http://dx.doi.org/10.1007/s00261-023-03961-7
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