Objectives:Magnetic resonance imaging plays a pivotal role in the management of locally advanced rectal cancer. This study aims to assess the correlation between magnetic resonance tumor regression grade and pathological tumor regression grade following neoadjuvant therapy in patients with locally advanced rectal cancer.Material and Methods:A retrospective analysis was conducted on 97 patients diagnosed with LARC (T3-T4 or any T stage with regional lymph node involvement) who underwent neoadjuvant chemoradiotherapy followed by radical surgery between 2014 and 2020. The correlation between mrTRG and pTRG was evaluated primarily using the weighted Kappa statistic. Additional clinical and imaging data were collected for a comprehensive analysis.Results:The median interval between completion of neoadjuvant therapy and restaging MRI was 40 days, with a median of 69 days from completion of chemoradiotherapy to surgery. The weighted Kappa was 0.27, indicating fair agreement between mrTRG and pTRG. MRI demonstrated a sensitivity of 52.1% and specificity of 81.6% for detecting a good response (pTRG 1–2). For identification of a complete response (pTRG 1), MRI showed a sensitivity of 10% and specificity of 98.7%.Conclusions:The correlation between mrTRG and pTRG shows fair agreement. Although MRI alone may not be sufficient to reliably predict pathological response, its high specificity suggests it can be a useful tool to confirm good and complete responses. Therefore, MRI should be integrated with other diagnostic methods, such as endoscopy and digital rectal examination, especially in organ preservation strategies. Moreover, MRI retains potential as a prognostic factor to guide clinical decision-making in LARC.
目的：磁共振成像在局部进展期直肠癌的治疗管理中具有关键作用。本研究旨在评估局部进展期直肠癌患者新辅助治疗后磁共振肿瘤退缩分级与病理肿瘤退缩分级之间的相关性。 材料与方法：回顾性分析了2014年至2020年间确诊为局部进展期直肠癌（T3-T4期或任何T分期伴区域淋巴结转移）并接受新辅助放化疗后行根治性手术的97例患者。主要采用加权Kappa统计量评估mrTRG与pTRG之间的相关性，并收集其他临床及影像学数据进行综合分析。 结果：新辅助治疗完成至再分期MRI检查的中位间隔时间为40天，从放化疗完成至手术的中位时间为69天。加权Kappa值为0.27，表明mrTRG与pTRG之间具有中等一致性。对于良好应答（pTRG 1-2）的检测，MRI的敏感性为52.1%，特异性为81.6%；而对于完全应答（pTRG 1）的识别，MRI的敏感性为10%，特异性为98.7%。 结论：mrTRG与pTRG之间呈中等程度相关。尽管单独使用MRI可能不足以可靠预测病理应答，但其高特异性提示其可作为确认良好及完全应答的有效工具。因此，MRI应与其他诊断方法（如内镜和直肠指检）结合使用，尤其在器官保留策略中。此外，MRI仍具备作为指导局部进展期直肠癌临床决策的预后因素的潜力。
Radiopathological Correlation in Locally Advanced Rectal Cancer After Neoadjuvant Treatment
肿瘤(癌症)患者之家