Send to:

Choose Destination
See comment in PubMed Commons below
Int J Colorectal Dis. 2013 Sep;28(9):1225-38. doi: 10.1007/s00384-013-1676-y. Epub 2013 Mar 21.

Is there a benefit in using magnetic resonance imaging in the prediction of preoperative neoadjuvant therapy response in locally advanced rectal cancer?

Author information

  • 1Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dongfang Road, Shanghai 200127, China.



This meta-analysis aimed to evaluate the accuracy of magnetic resonance imaging (MRI) in predicting responses in patients with locally advanced rectal cancer after preoperative neoadjuvant therapy.


Articles in English language relating to the accuracy of MRI for this utility were retrieved. Methodological quality was assessed by Quality Assessment of Diagnostic Accuracy Studies tool. Pooled estimation and subgroup analysis data were obtained by statistical analysis.


Fourteen studies involved 751 pathologically confirmed patients met the inclusion criteria. Methodological quality was relatively high. To predict histopathological response in locally advanced rectal cancer by MRI, the pooled sensitivity and specificity were 0.78 [95 % confidence intervals (CI), 0.65, 0.87] and 0.81 (95 % CI, 0.72, 0.87), respectively. Positive likelihood ratio and negative likelihood ratio were 4.1 (95 %CI, 2.9, 5.8) and 0.27 (95 % CI, 0.17, 0.43), respectively. Subgroup analysis showing that imaging was performed at 3.0 T MRI devices had higher pooled sensitivity (0.92, 95 % CI, 0.84, 1.00) than the subgroup of MRI with ≤1.5 T (0.68, 95 % CI, 0.53, 0.82) (p < 0.05).The sensitivity and specificity of T2-weighted imaging (T2WI) with diffusion-weighted imaging (DWI) were 0.92 (95 % CI, 0.81, 1.00) and 0.75 (95 % CI, 0.54, 0.95); those of T2WI alone were 0.64 (95 % CI, 0.47, 0.82) and 0.88 (95 % CI, 0.81, 0.94) (p > 0.05).


This meta-analysis indicates that MRI is an accurate tool in predicting pathologic response after preoperative therapy in patients with locally advanced rectal cancer. It is suggested to perform MRI by 3.0 T devices, which might be sensitive to identify responder. The addition of DWI to T2WI showed a non-significant improvement in sensitivity, which deserves further investigation.

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer
    Loading ...
    Write to the Help Desk