Accuracy of magnetic resonance imaging in predicting dentate line invasion in low rectal cancer Shota Tatsumoto

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Accuracy of magnetic resonance imaging in predicting dentate line invasion in low rectal cancer

Shota Tatsumoto¹; Takahiro Itoh¹; Junko Takahama¹; Nagaaki Marugami¹; Kiyoyuki Minamiguchi¹; Toshihiro Tanaka¹; Fumikazu Koyama²; Kohei Morita³; and Kimihiko Kichikawa¹

1 Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan

2 Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan

3 Department of Diagnostic Pathology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan

Corresponding author:

Shota Tatsumoto, M.D.

Department of Radiology, Nara Medical University 840 Shijo-cho, Kashihara 634-8522, Japan Tel: +81-744-22-3051

Fax: +81-744-25-7657

E-mail: [email protected]

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Funding:

None

Conflict of Interest:

The authors declare that they have no conflict of interest.

Ethical Statement:

The Ethics Committee of our institution approved this retrospective study (Approval No. 2219) and waived the requirement to obtain informed consent. Information about this study is presented on our institutional home page. All participants were given the opportunity to opt out of this study.

Manuscript type:

Original Article

Word count:

3214

E-mail:

Takahiro Itoh: [email protected] Junko Takahama: [email protected] Nagaaki Marugami: [email protected] Kiyoyuki Minamiguchi: [email protected] Toshihiro Tanaka: [email protected] Fumikazu Koyama: [email protected] Kohei Morita: [email protected] Kimihiko Kichikawa: [email protected]

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Abstract Purpose

To retrospectively assess the accuracy of magnetic resonance imaging (MRI) in predicting dentate line invasion in low rectal cancer.

Materials and methods

Eighty-one patients with primary rectal cancer were assessed by dynamic contrast-enhanced MRI. The location of the dentate line was assessed on MRI in 27 patients with upper-mid rectal cancer. Two observers independently evaluated the distance between the distal tumor edge and the MRI-defined dentate line in 54 patients with low rectal cancer, and the imaging and histological findings were compared.

Results

The MRI-defined dentate line was 24.0 ± 3.8 mm above the anal verge in patients with upper-mid rectal cancer. The dentate line invasion status agreed with the histological findings in 49/54 (91%) patients (κ = 0.72 [95% CI 0.50–0.95]) for observer 1, and in 51/54 (94%) patients (κ = 0.83 [0.65–1.00]) for observer 2 in patients with low rectal cancer. Interobserver agreement was good (κ = 0.83 [0.65–1.00]). The MRI- derived distance between the distal tumor edge and the dentate line had significant correlation with the histological distance (r = 0.86 for reader 1, 0.75 for observer 2).

Conclusion

MRI demonstrates high accuracy in predicting dentate line invasion in low rectal cancer.

Keywords:

Anal canal; Dentate line; Magnetic resonance imaging; Rectal cancer; Rectum

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