Purpose: To investigate whether quantitative parameters derived from dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) are correlated with angiogenesis and biologic aggressiveness of rectal cancer.Materials and Methods: A total of 46 patients with rectal cancer underwent DCE‐MRI. Using a two‐compartmental model, quantitative parameters (K^trans, k_ep, v_e, and iAUC) were calculated from the whole‐transverse region of interest (ROI) and high K^trans area ROI of entire tumors. Histological specimens were analyzed for tumor size; T/N stage; lymphatic, vascular, perineural invasion; expression of epidermal growth factor receptor (EGFR); and KRAS gene mutations. Tumor angiogenesis was evaluated based on the microvessel density (MVD) and the expression level of the vascular endothelial growth factor. Correlations of the DCE‐MRI parameters with histological markers and angiogenesis were determined using Student's t‐test and analysis of variance (ANOVA).Results: The mean k_ep from high K^trans area ROIs showed a significantly positive correlation with MVD (P = 0.030, r = 0.514, R² = 0.264). The mean k_ep from the whole‐transverse ROIs showed a significant inverse correlation with T stage (T1 vs. T2–4, P = 0.021). EGFR‐positive cancer displayed higher mean K^trans (P = 0.045) and k_ep (P = 0.038) than EGFR‐negative cancer in whole‐transverse ROIs.Conclusion: These preliminary results suggest that the determination of k_ep of high K^trans area permits the noninvasive estimation of tumor angiogenesis in rectal cancer and that DCE‐MRI parameters can be used as imaging biomarkers to predict the biologic aggressiveness of the tumor and patient prognosis. J. Magn. Reson. Imaging 2015;41:474–480.© 2013 Wiley Periodicals, Inc.

Sohn DK, et al. J Korean Med Assoc. 2015 May;58(5):420-432. http://dx.doi.org/10.5124/jkma.2015.58.5.420

AIM: To assess the role of computed tomography (CT) and magnetic resonance imaging (MRI) and establish imaging criteria of lymph node metastasis in early colorectal cancer. METHODS: One hundred and sixty patients with early colorectal cancer were evaluated for tumor location, clinical history of polypectomy, depth of tumor invasion, and lymph node metastasis. Two radiologists assessed preoperative CT and/or MRI for the primary tumor site detectability, the presence or absence of regional lymph node, and the size of the largest lymph node. Demographic, imaging, and pathologic findings were compared between the two groups of patients based on pathologic lymph node metastasis and optimal size criterion was obtained. RESULTS: The locations of tumor were ascending, transverse, descending, sigmoid colon, and rectum. One hundred and sixty early colorectal cancers were classified into 3 groups based on the pathological depth of tumor invasion; mucosa, submucosa, and depth unavailable. A total of 20 (12.5%) cancers with submucosal invasion showed lymph node metastasis. Lymph nodes were detected on CT or MRI in 53 patients. The detection rate and size of lymph nodes were significantly higher (P = 0.000, P = 0.044, respectively) in patients with pathologic nodal metastasis than in patients without nodal metastasis. Receiver operating curve analysis showed that a cut-off value of 4.1 mm is optimal with a sensitivity of 78.6% and specificity of 75%. CONCLUSION: The short diameter size criterion of ≥ 4.1 mm for metastatic lymph nodes was optimal for nodal staging in early colorectal cancer.

Immunoglobulin G4–related disease is a systemic fibroinflammatory disease that can affect multiple parts of the body, and the kidneys are the most frequently involved organs in the genitourinary sy... Immunoglobulin G4–related disease (IgG4-RD) is a systemic fibroinflammatory disease characterized by focal or diffuse organ infiltration of IgG4-bearing plasma cells. The diagnosis of IgG4-RD is ba...

Background: The clinical significance of pre-sarcopenia in colorectal cancer obstruction has not yet been described. The present study aimed to determine the short- and long-term oncologic impacts of pre-sarcopenia in obstructive colorectal cancer. Methods: We retrospectively analyzed 214 patients with obstructive colon cancer between January 2004 and December 2013. Initial staging computed tomography (CT) scans identified pre-sarcopenia and visceral obesity by measuring the muscle and visceral fat areas at the third lumbar vertebra level. Both short-term postoperative and long-term oncologic outcomes were analyzed. Results: Among all 214 patients, 71 (33.2%) were diagnosed with pre-sarcopenia. Pre-sarcopenia had a negative oncologic impact in both disease-free survival (DFS) and overall survival (OS), (hazard ratio [HR] = 1.86, 95% confidence interval [CI] 1.04–3.13, p = 0.037, and HR = 1.92, CI 1.02–3.60, p = 0.043, respectively). Visceral adiposity, body mass index (BMI), and neutrophil-lymphocyte ratio (NLR) did not significantly impact DFS and OS. Conclusion: Pre-sarcopenia is a clinical factor significantly associated with OS and DFS but not with short-term complications in obstructive colorectal cancer. In future, prospective studies should incorporate body composition data in patient risk assessments and oncologic prediction tools.