Yoo bee Han MD, Presenter: Nothing to Disclose

Soon Nam Oh MD, Abstract Co-Author: Nothing to Disclose

Dong Myung Yeo, Abstract Co-Author: Nothing to Disclose

Hong Seok Jang, Abstract Co-Author: Nothing to Disclose

Sung Eun Rha MD, Abstract Co-Author: Nothing to Disclose

Seung Eun Jung MD, Abstract Co-Author: Nothing to Disclose

Moon Hyung Choi MD, Abstract Co-Author: Nothing to Disclose

Jae Young Byun MD, Abstract Co-Author: Nothing to Disclose

To evaluate whether MR volumetric analysis in rectal cancer can predict the clinical outcome, tumor recurrence and disease-free survival[DFS], and to determine the most reliable method for predicting clinical outcome among tumor volume reduction ratio[TVRR] , tumor down-staging[TDS], and tumor response grade[TRG].

Seventy four patients who underwent preoperative concurrent chemoradiation therapy[CCRT] and following curative rectal surgery, between January 2007 and December 2010, were included in this study. Two radiologists being blind to clinical outcome measured tumor volume in consensus before and after CCRT on MRI. Tumor volume was manually traced on each T2 weighted axial image and was calculated by multiplying cross-sectional areas by section thickness. TVRR, TDS of T stage were assessed on MRI. The pathologic TRG, recurrence and DFS were assessed with medical record. We divided patients into two groups according to episode of recurrence. Difference of TVRR between two groups were assessed with student t-test, and the cut-off value of TVRR for predicting recurrence were evaluated with maximal chi-square method. Difference of TDS and TRG between two groups were estimated with chi-square test. The most reliable predicting parameter among TVRR, TDS, and TRG was evaluated with Cox regression analysis.

TVRR(p=0.002) and TRG(p=0.006) was significantly different between recurrent and non-recurrent groups, whereas TDS of T stage (p=0.448) was not. Mean follow up time for DFS was 36.98 ± 18.51 months. The cut-off value of TVRR was estimated as 61.38%. Between higher TVRR (>61.38%) and lower TVRR groups, DFS (p=0.00) and TRG(p < 0.01) were significantly different. TVRR was the most reliable predicting parameter. 

After CCRT, TVRR assessment on MRI can be a prognostic parameter for predicting tumor recurrence and DFS, as well as TRG. The cut-off value of TVRR was 61.38% in our study.

MR volumetry of rectal cancer can be a helpful predicting factor for clinical outcome in patients with CCRT. 

Han, Y, Oh, S, Yeo, D, Jang, H, Rha, S, Jung, S, Choi, M, Byun, J, Clinical Impact of the Tumor Volume Reduction Ratio in the Rectal Cancer Patients Following Preoperative Chemoradiation; A Comparison Study of Volumetric Measurement, Down-staging, and Tumor Response Grade .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017488.html