Radiology, Vol 189, 881-889, Copyright © 1993 by Radiological Society of North America

ARTICLES

Recurrent rectal cancer: diagnosis with dynamic MR imaging

M Muller-Schimpfle, G Brix, G Layer, P Schlag, R Engenhart, S Frohmuller, T Hess, I Zuna, W Semmler and G van Kaick
Research Program Radiological Diagnostics and Therapy, German Cancer Research Center, Heidelberg.

PURPOSE: To evaluate whether dynamic magnetic resonance (MR) imaging can increase the diagnostic accuracy in suspected local recurrence of rectal carcinoma. MATERIALS AND METHODS: Eighteen patients (seven men, 11 women, aged 26-78 years) with 19 suspect lesions were examined. T1- weighted (pre- and postcontrast) and T2-weighted spin-echo images were read by three observers. Computed tissue-specific enhancement parameters were obtained and displayed on gray-scale images (pharmacokinetic mapping). RESULTS: Reading of the spin-echo images yielded a sensitivity of 91%-100% (confidence interval, 67%, 100%), a specificity of 29%-43% (12%, 67%), and an accuracy of 71%-75% (48%, 91%). Analysis of the MR data showed greater (P = .0038) and faster (P = .0018) enhancement of malignant lesions (n = 12) compared with benign lesions (n = 7). CONCLUSION: Pharmacokinetic mapping of dynamic MR imaging data allows in vivo insight into tissue physiopathology, helping differentiate benign from malignant pelvic lesions in rectal cancer.

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