A Logistic Model Including Risk Factors for Lymph Node Metastasis Can Improve the Accuracy of Magnetic Resonance Imaging Diagnosis of Rectal Cancer

Ogawa, Shimpei; Itabashi, Michio; Hirosawa, Tomoichiro; Hashimoto, Takuzo; Bamba, Yoshiko; Kameoka, Shingo

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자료유형: 학술저널

저자정보: Ogawa, Shimpei (Department of Surgery II, Tokyo Women's Medical University School of Medicine) Itabashi, Michio (Department of Surgery II, Tokyo Women's Medical University School of Medicine) Hirosawa, Tomoichiro (Department of Surgery II, Tokyo Women's Medical University School of Medicine) Hashimoto, Takuzo (Department of Surgery II, Tokyo Women's Medical University School of Medicine) Bamba, Yoshiko (Department of Surgery II, Tokyo Women's Medical University School of Medicine) Kameoka, Shingo (Department of Surgery II, Tokyo Women's Medical University School of Medicine)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제16권 제2호

발행연도: 2015.1

수록면: 707 - 712 (6page)

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Background: To evaluate use of magnetic resonance imaging (MRI) and a logistic model including risk factors for lymph node metastasis for improved diagnosis. Materials and Methods: The subjects were 176 patients with rectal cancer who underwent preoperative MRI. The longest lymph node diameter was measured and a cut-off value for positive lymph node metastasis was established based on a receiver operating characteristic (ROC) curve. A logistic model was constructed based on MRI findings and risk factors for lymph node metastasis extracted from logistic-regression analysis. The diagnostic capabilities of MRI alone and those of the logistic model were compared using the area under the curve (AUC) of the ROC curve. Results: The cut-off value was a diameter of 5.47 mm. Diagnosis using MRI had an accuracy of 65.9%, sensitivity 73.5%, specificity 61.3%, positive predictive value (PPV) 62.9%, and negative predictive value (NPV) 72.2% [AUC: 0.6739 (95%CI: 0.6016-0.7388)]. Age (<59) (p=0.0163), pT (T3+T4) (p=0.0001), and BMI (<23.5) (p=0.0003) were extracted as independent risk factors for lymph node metastasis. Diagnosis using MRI with the logistic model had an accuracy of 75.0%, sensitivity 72.3%, specificity 77.4%, PPV 74.1%, and NPV 75.8% [AUC: 0.7853 (95%CI: 0.7098-0.8454)], showing a significantly improved diagnostic capacity using the logistic model (p=0.0002). Conclusions: A logistic model including risk factors for lymph node metastasis can improve the accuracy of MRI diagnosis of rectal cancer.

#Rectal cancer #perirectal lymph nodes #lymph node metastasis #magnetic resonance imaging #MRI)

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