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Staging of rectal cancer by double‐contrast MR imaging using the rectally administered superparamagnetic iron oxide contrast agent ferristene and IV gadodiamide injection: Results of a multicenter phase II trial
Author(s) -
Maier Andrea G.,
KerstingSommerhoff Barbara,
Reeders Jacques W.A.J.,
Judmaier Werner,
Annweiler Arnd A.,
Meusel Monika,
Wallengren Nils O.
Publication year - 2000
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/1522-2586(200011)12:5<651::aid-jmri1>3.0.co;2-r
Subject(s) - gadodiamide , medicine , magnetic resonance imaging , nuclear medicine , radiology , receiver operating characteristic , stage (stratigraphy) , gadoxetic acid , colorectal cancer , contrast (vision) , contrast effect , cancer , gadolinium dtpa , paleontology , artificial intelligence , biology , computer science
The aim of this study was to assess the accuracy of double‐contrast magnetic resonance imaging (MRI) with rectal application of the superparamagnetic iron oxide contrast agent (SPIO) ferristene and IV gadodiamide for preoperative staging of rectal cancer. In a randomized phase II dose‐ranging trial, 113 patients were studied preoperatively with one of four different formulations of ferristene (Abdoscan) as an enema before MRI. T1‐weighted spin‐echo (T1w SE) and T2w turbo spin‐echo (TSE) single‐contrast images were obtained as well as T1w SE and gradient‐echo (GRE) double‐contrast images after IV gadodiamide injection (Omniscan). Images were assessed qualitatively, and TNM tumor stage was compared with histopathology. High‐viscosity ferristene formulations were superior to low‐viscosity formulations in tumor staging (accuracy 90% vs 74%, P < 0.01). There was no significant difference between high and low iron content ferristene. MRI had a sensitivity of 97%, specificity of 50%, and accuracy of 82% for staging of rectal carcinoma higher than T2 stage. At receiver operator characteristic (ROC) analysis, MR differentiation between T1/T2 and T3/T4 tumor stages yielded a ROC index of 0.848. Double‐contrast MRI is an accurate method for preoperative staging of rectal cancer. J. Magn. Reson. Imaging 2000;12:651–660. © 2000 Wiley‐Liss, Inc.