Does gadolinium-based contrast material improve diagnostic accuracy of local invasion in rectal cancer MRI? A multireader study Journal Article


Authors: Gollub, M. J.; Lakhman, Y.; Mcginty, K.; Weiser, M. R.; Sohn, M.; Zheng, J.; Shia, J.
Article Title: Does gadolinium-based contrast material improve diagnostic accuracy of local invasion in rectal cancer MRI? A multireader study
Abstract: OBJECTIVE. The purpose of this study was to compare reader accuracy and agreement on rectal MRI with and without gadolinium administration in the detection of T4 rectal cancer. MATERIALS AND METHODS. In this study, two radiologists and one fellow independently interpreted all posttreatment MRI studies for patients with locally advanced or recurrent rectal cancer using unenhanced images alone or combined with contrast-enhanced images, with a minimum interval of 4 weeks. Readers evaluated involvement of surrounding structures on a 5-point scale and were blinded to pathology and disease stage. Sensitivity, specificity, negative predictive value, positive predictive value, and AUC were calculated and kappa statistics were used to describe interreader agreement. RESULTS. Seventy-two patients (38 men and 34 women) with a mean age of 61 years (range, 32-86 years) were evaluated. Fifteen patients had 32 organs invaded. Global AUCs without and with gadolinium administration were 0.79 and 0.77, 0.91 and 0.86, and 0.83 and 0.78 for readers 1, 2, and 3, respectively. AUCs before and after gadolinium administration were similar. Kappa values before and after gadolinium administration for pairs of readers ranged from 0.5 to 0.7. CONCLUSION. On the basis of pathology as a reference standard, the use of gadolinium during rectal MRI did not significantly improve radiologists' agreement or ability to detect T4 disease.
Keywords: adult; aged; aged, 80 and over; middle aged; retrospective studies; comparative study; gadolinium; cancer staging; nuclear magnetic resonance imaging; magnetic resonance imaging; neoplasm staging; diagnostic accuracy; observer variation; pathology; retrospective study; image enhancement; contrast medium; contrast media; neoplasm invasiveness; rectal neoplasms; rectum tumor; mri; rectal cancer; tumor invasion; reader performance; very elderly; humans; human; male; female; diagnostic use; statistics and numerical data
Journal Title: American Journal of Roentgenology
Volume: 204
Issue: 2
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2015-02-01
Start Page: W160
End Page: W167
Language: English
DOI: 10.2214/ajr.14.12599
PUBMED: 25615776
PROVIDER: scopus
PMCID: PMC4518447
DOI/URL:
Notes: Export Date: 2 July 2015 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Yuliya Lakhman
    97 Lakhman
  2. Junting Zheng
    200 Zheng
  3. Marc J Gollub
    209 Gollub
  4. Jinru Shia
    720 Shia
  5. Martin R Weiser
    538 Weiser
  6. Michael J Sohn
    13 Sohn