World journal of gastrointestinal surgery · 2025
Value of high-resolution magnetic resonance imaging and dynamic contrast-enhanced scanning in the preoperative diagnosis of rectal cancer in older patients.
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Gao Yan-Lei, Li Hui-Na, Wang Qiang, Shen Wen
Аннотация
BACKGROUND: Rectal cancer is a common malignant tumor of the digestive system, with older patients representing the predominantly affected population. Magnetic resonance imaging (MRI) has been widely applied in preoperative tumor assessment; however, the value of high-resolution MRI (HR-MRI) combined with dynamic contrast-enhanced (DCE) scanning in the preoperative diagnosis of rectal cancer in older patients remains unclear.
AIM: To evaluate the value of HR-MRI combined with DCE scanning in the preoperative diagnosis of rectal cancer in older patients.
METHODS: This retrospective study included 148 consecutive older female patients with rectal cancer who were treated at our hospital between December 2020 and December 2024. Clinical data and HR-MRI and DCE scan findings were collected. Histopathological examination after surgical resection served as the gold standard. The diagnostic accuracy of MRI for preoperative T and N staging was calculated. Consistency, sensitivity, and specificity between HR-MRI combined with DCE scanning and pathological staging were analyzed using the k test.
RESULTS: Among the 148 patients, the overall accuracy of T staging was 84.5%. Sensitivity for T1, T2, T3, and T4 staging was 75.00%, 62.50%, 89.47%, and 90.48%, respectively, whereas specificity was 100.00%, 94.35%, 79.25%, and 96.06%, respectively. T staging based on HR-MRI combined with DCE scanning showed good agreement with pathological staging (k = 0.8176, P < 0.001). For N staging, sensitivity and specificity were 54.88% and 84.85% for N0, 36.96% and 72.55% for N1, and 70.00% and 73.44% for N2, respectively; agreement with pathological N staging was poor (k = 0.259, P < 0.001).
CONCLUSION: HR-MRI combined with DCE scanning demonstrates high diagnostic accuracy for T staging of rectal cancer in older patients and can provide a theoretical basis for treatment planning. However, its diagnostic accuracy for N staging requires improvement.
AIM: To evaluate the value of HR-MRI combined with DCE scanning in the preoperative diagnosis of rectal cancer in older patients.
METHODS: This retrospective study included 148 consecutive older female patients with rectal cancer who were treated at our hospital between December 2020 and December 2024. Clinical data and HR-MRI and DCE scan findings were collected. Histopathological examination after surgical resection served as the gold standard. The diagnostic accuracy of MRI for preoperative T and N staging was calculated. Consistency, sensitivity, and specificity between HR-MRI combined with DCE scanning and pathological staging were analyzed using the k test.
RESULTS: Among the 148 patients, the overall accuracy of T staging was 84.5%. Sensitivity for T1, T2, T3, and T4 staging was 75.00%, 62.50%, 89.47%, and 90.48%, respectively, whereas specificity was 100.00%, 94.35%, 79.25%, and 96.06%, respectively. T staging based on HR-MRI combined with DCE scanning showed good agreement with pathological staging (k = 0.8176, P < 0.001). For N staging, sensitivity and specificity were 54.88% and 84.85% for N0, 36.96% and 72.55% for N1, and 70.00% and 73.44% for N2, respectively; agreement with pathological N staging was poor (k = 0.259, P < 0.001).
CONCLUSION: HR-MRI combined with DCE scanning demonstrates high diagnostic accuracy for T staging of rectal cancer in older patients and can provide a theoretical basis for treatment planning. However, its diagnostic accuracy for N staging requires improvement.