Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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A Logistic Model Including Risk Factors for Lymph Node Metastasis Can Improve the Accuracy of Magnetic Resonance Imaging Diagnosis of Rectal Cancer

  • Ogawa, Shimpei (Department of Surgery II, Tokyo Women's Medical University School of Medicine) ;
  • Itabashi, Michio (Department of Surgery II, Tokyo Women's Medical University School of Medicine) ;
  • Hirosawa, Tomoichiro (Department of Surgery II, Tokyo Women's Medical University School of Medicine) ;
  • Hashimoto, Takuzo (Department of Surgery II, Tokyo Women's Medical University School of Medicine) ;
  • Bamba, Yoshiko (Department of Surgery II, Tokyo Women's Medical University School of Medicine) ;
  • Kameoka, Shingo (Department of Surgery II, Tokyo Women's Medical University School of Medicine)
  • Published : 2015.02.25
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Abstract

Background: To evaluate use of magnetic resonance imaging (MRI) and a logistic model including risk factors for lymph node metastasis for improved diagnosis. Materials and Methods: The subjects were 176 patients with rectal cancer who underwent preoperative MRI. The longest lymph node diameter was measured and a cut-off value for positive lymph node metastasis was established based on a receiver operating characteristic (ROC) curve. A logistic model was constructed based on MRI findings and risk factors for lymph node metastasis extracted from logistic-regression analysis. The diagnostic capabilities of MRI alone and those of the logistic model were compared using the area under the curve (AUC) of the ROC curve. Results: The cut-off value was a diameter of 5.47 mm. Diagnosis using MRI had an accuracy of 65.9%, sensitivity 73.5%, specificity 61.3%, positive predictive value (PPV) 62.9%, and negative predictive value (NPV) 72.2% [AUC: 0.6739 (95%CI: 0.6016-0.7388)]. Age (<59) (p=0.0163), pT (T3+T4) (p=0.0001), and BMI (<23.5) (p=0.0003) were extracted as independent risk factors for lymph node metastasis. Diagnosis using MRI with the logistic model had an accuracy of 75.0%, sensitivity 72.3%, specificity 77.4%, PPV 74.1%, and NPV 75.8% [AUC: 0.7853 (95%CI: 0.7098-0.8454)], showing a significantly improved diagnostic capacity using the logistic model (p=0.0002). Conclusions: A logistic model including risk factors for lymph node metastasis can improve the accuracy of MRI diagnosis of rectal cancer.

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References

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  1. Prediction of lateral pelvic lymph node metastasis from lower rectal cancer using magnetic resonance imaging and risk factors for metastasis: Multicenter study of the Lymph Node Committee of the Japanese Society for Cancer of the Colon and Rectum vol.32, pp.10, 2017, https://doi.org/10.1007/s00384-017-2874-9