ArticleEuropean radiology2017
Diffusion-weighted MRI to assess response to chemoradiotherapy in rectal cancer: main interpretation pitfalls and their use for teaching.
Article in European radiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.
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Who cites it
43 citing papers in PubMed, 1 synthesis or guideline pooled it, 90 citations in OpenAlex.
- MRI Assessment of Complete Response to Preoperative Chemoradiation Therapy for Rectal Cancer: 2020 Guide for Practice from the Korean Society of Abdominal Radiology.Korean journal of radiology · 2020Pooled it
- Quantitative MRI T1 relaxation time as a biomarker of complete response in rectal cancer six weeks after neoadjuvant therapy: a prospective study.Clinical and translational radiation oncology · 2026Article
- MRI to guide clinical management of rectal cancer: updated consensus recommendations from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR): PART II-Restaging and response evaluation.European radiology · 2026Article
- Value of whole-body diffusion-weighted MRI for the prediction of surgical and clinical outcome after neoadjuvant chemotherapy in advanced ovarian cancer.British journal of cancer · 2026Article
- A multimodal interpretable deep learning-radiomics framework for predicting lymph node metastasis following neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a multicenter validation study.NPJ precision oncology · 2026Article
- Multiparametric MRI with pea pod sign and muscularis propria striped enhancement improves T2 vs T3a-b rectal cancer staging accuracy.European radiology · 2026Article
- The predictive value of multi-phase contrast-enhanced MRI for pathological complete response after neoadjuvant chemoradiotherapy in rectal cancer.Frontiers in oncology · 2026Article
- The Landmark Series: Organ Preservation in Rectal Cancer-The Watch and Wait Strategy.Annals of surgical oncology · 2025Review
- MRI for Rectal Cancer: Updates and Controversies-AJR. American journal of roentgenology · 2025Review
- MRI radiomic study on prediction of nonenlarged lymph node metastasis of rectal cancer: reduced field-of-view versus conventional DWI.European radiology experimental · 2025Article
- Predicting disease-free survival in locally advanced rectal cancer using a prognostic model based on pretreatment b-value threshold map and postoperative pathologic features.Japanese journal of radiology · 2025Article
- A multivariate model of IVIM-DWI in the preoperative diagnosis of tumor budding grade in rectal cancer.Frontiers in oncology · 2025Article
- The Role of Predictive and Prognostic MRI-Based Biomarkers in the Era of Total Neoadjuvant Treatment in Rectal Cancer.Cancers · 2024Review
- The application of the golden-angle radial sparse parallel technique in T restaging of locally advanced rectal cancer after neoadjuvant chemoradiotherapy.Abdominal radiology (New York) · 2024Article
- Sense and non-sense of imaging in the era of organ preservation for rectal cancer.The British journal of radiology · 2023Review
- A primer on rectal MRI in patients on watch-and-wait treatment for rectal cancer.Abdominal radiology (New York) · 2023Review
- Mucinous Degeneration on MRI After Neoadjuvant Therapy in Patients With Rectal Adenocarcinoma: Frequency and Association With Clinical Outcomes.AJR. American journal of roentgenology · 2023Article
- High-resolution integrated dynamic shimming diffusion-weighted imaging (DWI) in the assessment of rectal cancer.European radiology · 2023Article
- Feasibility of high-resolution readout-segmented echo-planar imaging with simultaneous multislice imaging in assessing rectal cancer.Abdominal radiology (New York) · 2023Article
- [Rectal cancer update: postneoadjuvant staging].Radiologie (Heidelberg, Germany) · 2023Review
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Authors and funding
15 authors at 10 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo establish the most common image interpretation pitfalls for non-expert readers using diffusion-weighted imaging (DWI) to assess response to chemoradiotherapy in patients with rectal cancer and to explore the use of these pitfalls in an expert teaching setting.
methodsTwo independent non-expert readers (R1 and R2) scored the restaging DW MRI scans (b1,000 DWI, in conjunction with ADC maps and T2-W MRI scans for anatomical reference) in 100 patients for the likelihood of a complete response versus residual tumour using a five-point confidence score. The readers received expert feedback and the final response outcome for each case. The supervising expert documented any potential interpretation errors/pitfalls discussed for each case to identify the most common pitfalls.
resultsThe most common pitfalls were the interpretation of low signal on the ADC map, small susceptibility artefacts, T2 shine-through effects, suboptimal sequence angulation and collapsed rectal wall. Diagnostic performance (area under the ROC curve) was 0.78 (R1) and 0.77 (R2) in the first 50 patients and 0.85 (R1) and 0.85 (R2) in the final 50 patients.
conclusionsFive main image interpretation pitfalls were identified and used for teaching and feedback. Both readers achieved a good diagnostic performance with an AUC of 0.85. KEY POINTS: • Fibrosis appears hypointense on an ADC map and should not be mistaken for tumour. • Susceptibility artefacts on rectal DWI are an important potential pitfall. • T2 shine-through on rectal DWI is an important potential pitfall. • These pitfalls are useful to teach non-experts how to interpret rectal DWI.
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