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Preoperative Evaluation of Lymphovascular Invasion Using High-Resolution Pelvic Magnetic Resonance in Patients With Rectal Cancer: A 2-Year Follow-up Study

Kim, Yaena MD; Chung, Jae-Joon MD; Yu, Jeong-Sik MD; Cho, Eun-Suk MD; Kim, Joo Hee MD

Journal of Computer Assisted Tomography: July/August 2013 - Volume 37 - Issue 4 - p 583–588
doi: 10.1097/RCT.0b013e31828d616a
Abdominal Imaging

Objectives: The objectives of this study were to preoperatively evaluate lymphovascular invasion (LVI) using pelvic magnetic resonance (MR) in patients with rectal cancer and to determine the correlation with distant metastasis rate.

Methods: If the mesorectal perivascular infiltrative signal was visible on pelvic MR imaging, the possibility of LVI was recorded. Distant metastatic lesions were also recorded at the time of the initial diagnostic workup and over a 2-year follow-up period.

Results: Fifteen (68.2%) of the 22 LVI patients showed mesorectal perivascular infiltrative signals on pelvic MRI. For the prediction of LVI in rectal cancer, MR had a sensitivity of 68.2% and a specificity of 93.2. The initial distant metastasis rate was significantly higher in patients with MR LVI (52%) than in patients without MR LVI (5.7%) (P < 0.0001).

Conclusions: On pelvic MR, the presence of mesorectal perivascular infiltration by nodes is a specific sign of LVI in rectal cancer, and the presence of LVI is a predictor of distant metastasis.

From the Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Received for publication August 7, 2012; accepted February 14, 2013.

Reprints: Joo Hee Kim, MD, Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 612 Eonjuro, Gangnam-gu, Seoul, Korea (e-mail: pavane@yuhs.ac).

This work was supported by a faculty research grant of Yonsei University College of Medicine for 2012 (6-2012-0096).

The authors report no conflicts of interest.

© 2013 by Lippincott Williams & Wilkins