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.

Abstract

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.

• Authors: A G Maier, B Kersting-Sommerhoff, J W Reeders, W Judmaier, W Schima, A A Annweiler, M Meusel, N O Wallengren
• Journal: Journal of magnetic resonance imaging : JMRI (J Magn Reson Imaging) Vol. 12 Issue 5 Pg. 651-60 (Nov 2000) ISSN: 1053-1807 [Print] United States
• PMID: 11050634 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Contrast Media
• Ferric Compounds
• ferristene
• gadodiamide
• Gadolinium DTPA

Topics

• Adenocarcinoma (diagnosis, pathology, surgery)
• Administration, Rectal
• Adult
• Aged
• Biopsy, Needle
• Chi-Square Distribution
• Contrast Media
• Dose-Response Relationship, Drug
• Female
• Ferric Compounds
• Gadolinium DTPA
• Humans
• Image Processing, Computer-Assisted
• Injections, Intravenous
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Neoplasm Staging (methods)
• Preoperative Care
• Probability
• ROC Curve
• Rectal Neoplasms (diagnosis, pathology, surgery)
• Sensitivity and Specificity