TY - JOUR
T1 - Predicting response to chemoradiotherapy in rectal cancer via visual morphologic assessment and staging on baseline MRI
T2 - a multicenter and multireader study
AU - el Khababi, Najim
AU - Beets-Tan, Regina G. H.
AU - Tissier, Renaud
AU - Lahaye, Max J.
AU - Maas, Monique
AU - Curvo-Semedo, Luís
AU - Dresen, Raphaëla C.
AU - Nougaret, Stephanie
AU - Beets, Geerard L.
AU - Lambregts, Doenja M. J.
AU - on behalf of the rectal MRI study group
AU - Bakers, Frans C. H.
AU - Barros, Perla
AU - Bauer, Ferdinand
AU - de Bie, Shira H.
AU - Ballantyne, Stuart
AU - Dutra, Joanna Brayner
AU - Buskov, Laura
AU - Bogveradze, Nino
AU - Bosma, Gerlof P. T.
AU - Cappendijk, Vincent C.
AU - Castagnoli, Francesca
AU - Charalampos, Sotiriadis
AU - Delli Pizzi, Andrea
AU - Digby, Michael
AU - Geenen, Remy W. F.
AU - van Griethuysen, Joost J. M.
AU - Lafrance, Julie
AU - Mahajan, Vandana
AU - Malekzadeh, Sonaz
AU - Neijenhuis, Peter A.
AU - Peterson, Gerald M.
AU - Pieters, Indra
AU - Schurink, Niels W.
AU - Smit, Ruth
AU - Veeken, Cornelis J.
AU - Vliegen, Roy F. A.
AU - Wray, Andrew
AU - Zeina, Abdel-Rauf
N1 - Funding Information: This study was partly funded by the Dutch Cancer Society. Publisher Copyright: © 2023, The Author(s).
PY - 2023/10/1
Y1 - 2023/10/1
N2 - 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: [Figure not available: see fulltext.].
AB - 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: [Figure not available: see fulltext.].
KW - Chemoradiotherapy
KW - Magnetic resonance imaging
KW - Rectal cancer
KW - Response
UR - http://www.scopus.com/inward/record.url?scp=85163027593&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00261-023-03961-7
DO - https://doi.org/10.1007/s00261-023-03961-7
M3 - Article
C2 - 37358604
SN - 2366-004X
VL - 48
SP - 3039
EP - 3049
JO - Abdominal Radiology
JF - Abdominal Radiology
IS - 10
ER -