MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer

Beomseok Sohn, Joon seok Lim, Honsoul Kim, Sungmin Myoung, Junjeong Choi, Namkyu Kim, Myeong Jin Kim

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Abstract

Objectives: To determine whether magnetic resonance imaging (MRI)-detected extramural vascular invasion (EMVI) could predict synchronous distant metastases in rectal cancer. Methods: Patients who underwent rectal MRI between July 2011 and December 2012 were screened. This study included 447 patients with pathologically confirmed rectal adenocarcinoma who had undergone MRI without previous treatment. Distant metastases were recorded at the initial work-up and over a 6-month follow-up. Univariate/multivariate logistic regression models were used to determine the risk of metastasis. The diagnostic performance was calculated using pathologic lymphovascular invasion (LVI) as a gold standard. Results: Among 447 patients, 79 patients (17.7 %) were confirmed to have distant metastases. Three MRI features are significantly associated with a high risk of distant metastasis: positive EMVI (odds ratio 3.02), high T stage (odds ratio 2.10) and positive regional lymph node metastasis (odds ratio 6.01). EMVI in a large vessel (≥3 mm) had a higher risk for metastasis than EMVI in a small vessel (<3 mm). Sensitivity, specificity and accuracy of MRI-detected EMVI were 28.2 %, 94.0 % and 80.3 %, respectively. Conclusions: MRI-detected EMVI is an independent risk factor for synchronous metastasis in rectal cancer. EMVI in large vessels is a stronger risk factor for distant metastasis than EMVI in small vessels. Key points: • EMVI, LN metastasis and T staging on MRI are risk factors for metastasis. • EMVI in large vessels has greater risk for metastasis than in small vessels. • Regional LN metastasis on MRI has highest risk for predicting metastasis. • MR findings could be helpful for selecting patients at high risk for metastasis.

Original languageEnglish
Pages (from-to)1347-1355
Number of pages9
JournalEuropean Radiology
Volume25
Issue number5
DOIs
Publication statusPublished - 2015 May 1

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Rectal Neoplasms
Blood Vessels
Magnetic Resonance Imaging
Neoplasm Metastasis
Odds Ratio
Logistic Models
Adenocarcinoma

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Sohn, Beomseok ; Lim, Joon seok ; Kim, Honsoul ; Myoung, Sungmin ; Choi, Junjeong ; Kim, Namkyu ; Kim, Myeong Jin. / MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer. In: European Radiology. 2015 ; Vol. 25, No. 5. pp. 1347-1355.
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abstract = "Objectives: To determine whether magnetic resonance imaging (MRI)-detected extramural vascular invasion (EMVI) could predict synchronous distant metastases in rectal cancer. Methods: Patients who underwent rectal MRI between July 2011 and December 2012 were screened. This study included 447 patients with pathologically confirmed rectal adenocarcinoma who had undergone MRI without previous treatment. Distant metastases were recorded at the initial work-up and over a 6-month follow-up. Univariate/multivariate logistic regression models were used to determine the risk of metastasis. The diagnostic performance was calculated using pathologic lymphovascular invasion (LVI) as a gold standard. Results: Among 447 patients, 79 patients (17.7 {\%}) were confirmed to have distant metastases. Three MRI features are significantly associated with a high risk of distant metastasis: positive EMVI (odds ratio 3.02), high T stage (odds ratio 2.10) and positive regional lymph node metastasis (odds ratio 6.01). EMVI in a large vessel (≥3 mm) had a higher risk for metastasis than EMVI in a small vessel (<3 mm). Sensitivity, specificity and accuracy of MRI-detected EMVI were 28.2 {\%}, 94.0 {\%} and 80.3 {\%}, respectively. Conclusions: MRI-detected EMVI is an independent risk factor for synchronous metastasis in rectal cancer. EMVI in large vessels is a stronger risk factor for distant metastasis than EMVI in small vessels. Key points: • EMVI, LN metastasis and T staging on MRI are risk factors for metastasis. • EMVI in large vessels has greater risk for metastasis than in small vessels. • Regional LN metastasis on MRI has highest risk for predicting metastasis. • MR findings could be helpful for selecting patients at high risk for metastasis.",
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MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer. / Sohn, Beomseok; Lim, Joon seok; Kim, Honsoul; Myoung, Sungmin; Choi, Junjeong; Kim, Namkyu; Kim, Myeong Jin.

In: European Radiology, Vol. 25, No. 5, 01.05.2015, p. 1347-1355.

Research output: Contribution to journalArticle

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T1 - MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer

AU - Sohn, Beomseok

AU - Lim, Joon seok

AU - Kim, Honsoul

AU - Myoung, Sungmin

AU - Choi, Junjeong

AU - Kim, Namkyu

AU - Kim, Myeong Jin

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N2 - Objectives: To determine whether magnetic resonance imaging (MRI)-detected extramural vascular invasion (EMVI) could predict synchronous distant metastases in rectal cancer. Methods: Patients who underwent rectal MRI between July 2011 and December 2012 were screened. This study included 447 patients with pathologically confirmed rectal adenocarcinoma who had undergone MRI without previous treatment. Distant metastases were recorded at the initial work-up and over a 6-month follow-up. Univariate/multivariate logistic regression models were used to determine the risk of metastasis. The diagnostic performance was calculated using pathologic lymphovascular invasion (LVI) as a gold standard. Results: Among 447 patients, 79 patients (17.7 %) were confirmed to have distant metastases. Three MRI features are significantly associated with a high risk of distant metastasis: positive EMVI (odds ratio 3.02), high T stage (odds ratio 2.10) and positive regional lymph node metastasis (odds ratio 6.01). EMVI in a large vessel (≥3 mm) had a higher risk for metastasis than EMVI in a small vessel (<3 mm). Sensitivity, specificity and accuracy of MRI-detected EMVI were 28.2 %, 94.0 % and 80.3 %, respectively. Conclusions: MRI-detected EMVI is an independent risk factor for synchronous metastasis in rectal cancer. EMVI in large vessels is a stronger risk factor for distant metastasis than EMVI in small vessels. Key points: • EMVI, LN metastasis and T staging on MRI are risk factors for metastasis. • EMVI in large vessels has greater risk for metastasis than in small vessels. • Regional LN metastasis on MRI has highest risk for predicting metastasis. • MR findings could be helpful for selecting patients at high risk for metastasis.

AB - Objectives: To determine whether magnetic resonance imaging (MRI)-detected extramural vascular invasion (EMVI) could predict synchronous distant metastases in rectal cancer. Methods: Patients who underwent rectal MRI between July 2011 and December 2012 were screened. This study included 447 patients with pathologically confirmed rectal adenocarcinoma who had undergone MRI without previous treatment. Distant metastases were recorded at the initial work-up and over a 6-month follow-up. Univariate/multivariate logistic regression models were used to determine the risk of metastasis. The diagnostic performance was calculated using pathologic lymphovascular invasion (LVI) as a gold standard. Results: Among 447 patients, 79 patients (17.7 %) were confirmed to have distant metastases. Three MRI features are significantly associated with a high risk of distant metastasis: positive EMVI (odds ratio 3.02), high T stage (odds ratio 2.10) and positive regional lymph node metastasis (odds ratio 6.01). EMVI in a large vessel (≥3 mm) had a higher risk for metastasis than EMVI in a small vessel (<3 mm). Sensitivity, specificity and accuracy of MRI-detected EMVI were 28.2 %, 94.0 % and 80.3 %, respectively. Conclusions: MRI-detected EMVI is an independent risk factor for synchronous metastasis in rectal cancer. EMVI in large vessels is a stronger risk factor for distant metastasis than EMVI in small vessels. Key points: • EMVI, LN metastasis and T staging on MRI are risk factors for metastasis. • EMVI in large vessels has greater risk for metastasis than in small vessels. • Regional LN metastasis on MRI has highest risk for predicting metastasis. • MR findings could be helpful for selecting patients at high risk for metastasis.

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