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Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI

  • Oncology
  • Published:
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Abstract

Objectives

To evaluate the feasibility of mesorectal vascular invasion (MVI) in predicting early distant metastasis developed within 1 year of diagnosis of T3 rectal cancer using magnetic resonance imaging (MRI)

Methods

Sixty-five patients with T3 rectal cancer (early metastasis, n = 28; non-metastasis, n = 37) were enrolled in this study. Early distant metastases developed in 28 patients (liver, n = 15; lung, n = 9; both, n = 4). Logistic regression was used to determine the independent predictors for early distant metastasis.

Results

In univariate analysis, tumour location, carcinoembryonic antigen (CEA), lymphovascular invasion (LVI), MRI-detected MVI, and mesorectal fat infiltration (MFI) (odds ratio [OR], 4.533, 9.583, 5.539, 27.046, and 5.539, respectively) were associated with early distant metastasis. Multivariate analysis demonstrated that MVI (OR, 29.949; P < 0.002) and LVI (OR, 6.684; P = 0.033) were independent factors for early distant metastasis. Specificity and positive predictive value (PPV) of MVI (94.59 %, and 89.47 %, respectively) were significantly higher than those of LVI (64.86 %, and 61.76 %), but sensitivity and negative predictive value were not significantly different between MVI (60.71 %, and 76.09 %) and LVI (75.00 %, and 77.42 %).

Conclusions

While sensitivity of MRI-detected MVI was equal to that of CEA in predicting early distant metastasis from T3 rectal cancer, specificity and PPV may be improved by assessing MVI.

Key points

• Mesorectal vascular invasion (MVI) may be a radiologic prognostic factor for rectal cancer.

• Specificity of MVI was higher than lymphovascular invasion in predicting early metastasis.

• Mesorectal vascular invasion may be a better predictor for early distant metastasis.

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Abbreviations

MVI:

mesorectal vascular invasion

CEA:

carcinoembryonic antigen

MFI:

mesorectal fat infiltration

LVI:

lymphovascular invasion

OR:

odds ratio

MRI:

magnetic resonance imaging

PACS:

picture archiving and communication system

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Acknowledgments

The scientific guarantor of this publication is Jai Keun Kim. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise (Jai Keun Kim). Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, 443-380, Gyeonggi-do, Republic of Korea

    Young Chul Kim, Jai Keun Kim & Jei Hee Lee

  2. Department of Diagnostic Radiology, Institute of Gastroenterology, Research Institute of Radiological Science, Yonsei University Health system, Seoul, Republic of Korea

    Myeong-Jin Kim

  3. Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea

    Young Bae Kim

  4. Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea

    Sung Jae Shin

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  1. Young Chul Kim
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Correspondence to Jai Keun Kim.

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Kim, Y.C., Kim, J.K., Kim, MJ. et al. Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI. Eur Radiol 26, 297–305 (2016). https://doi.org/10.1007/s00330-015-3837-6

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  • DOI: https://doi.org/10.1007/s00330-015-3837-6

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