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Ivanova D.A., Safonova M.A.
The Informative Value of Magnetic Resonance Imaging in the Diagnosis of Rectal Tumor Involvement Against the Background of Combined Treatment
Keywords: radiation diagnostics, rectal cancer, magnetic resonance imaging, chemotherapy, radiation therapy
The aim of the study is to prove the informative value of magnetic resonance imaging in the diagnosis of rectal tumor involvement against the background of combined treatment for the patients (chemotherapy + radiation therapy) on the basis of the AI "Republican Oncological Dispensary", Cheboksary. All patients underwent magnetic resonance imaging on Elekta Synergy linear accelerator with a multi-leaf collimator, an integrated XVI X-ray volumetric imaging system and iViewGT portal imaging system, Mosaiq information and control system. Statistical processing was performed using standard methods of medical statistics using the SPSS Statistics package (version 17.0), arithmetic mean (M), standard deviation from the general mean age, mean value errors (m), Student's t-test were also calculated. Magnetic resonance imaging diagnostics made it possible to identify and dynamically control the change in the tumor involvement of the rectum against the background of the treatment: a change in the localization of the tumor in different parts of the rectum, a change in localization depending on the distance from the anal margin, a change in the thickness of the tumor wall, a change in the size and number of lymph nodes. Extramural venous invasion (EMVI), marginal resection boundary (CRM) of the tumor and invasion into surrounding tissues after surgical intervention were evaluated. This article examines the incidence of rectal cancer depending on age, gender, complaints, oncological history, risk factors contributing to the development of this pathology, as well as the presence of concomitant diseases that aggravate treatment. According to the results of the study, rectal cancer is revealed to be most often found in people aged 60–70, while men are most susceptible to the disease. According to histomorphological data, adenocarcinoma prevailed in 94 persons. Rectal cancer before and after chemoradiotherapy, according to magnetic resonance imaging (MRI) findings, prevailed in the rectal lower ampulla (before chemoradiotherapy – in 51 persons, after chemoradiotherapy – in 48), while the malignant neoplasm was at the distance of 21-30 mm from the anal margin in 27 persons, with the average wall thickness of 21.5 mm according to MRI findings before chemoradiotherapy and 13.9 mm after chemoradiotherapy. The difference in the average wall thickness according to the findings of two MRI studies was 7.61 mm (33.3%), which indicates the effectiveness of chemoradiotherapy.
References
- Gistologicheskoe issledovanie: pokazaniya, vidy [Histological examination: indications, types] Available as: https://medica24.ru/uslugi/gistologicheskoe-issledovanie (Accessed Date 2022, June 17).
- Klassifikatsiya TNM – opisanie onkologicheskogo termina [TNM classification – description of the oncological term]. Available at: https://www.hospital-israel.ru/onkologiya/mezhdunarodnaya-tnm-klassifikaciya-onkologicheskix-opuxolej (Accessed Date 2022, June 17).
- Klinicheskie rekomendatsii: Rak pryamoi kishki [Clinical recommendations: Rectal cancer] Available as: https://oncology-association.ru/wp-content/uploads/2020/09/rak_prjamoj_kishki.pdf (Accessed Date 2022, June 17).
- Aliev V.A. et al. Klinicheskie rekomendatsii po diagnostike i lecheniyu bol’nykh rakom pryamoi kishki [Clinical recommendations for the diagnosis and treatment of patients with rectal cancer]. Moscow, 2014, 15 p.
- Klinicheskie rekomendatsii po onkologii: Rak pryamoi kishki [Clinical recommendations for oncology: Rectal cancer]. Available as: http://oncology.ru/specialist/treatment/references/actual/554.pdf (Accessed Date 2022, June 17).
- Lechenie raka pryamoi kishki. Operatsii pri rake pryamoi kishki [Treatment of rectal cancer. Operations for rectal cancer] Available as: https://meduniver.com/Medical/Xirurgia/941.html (Accessed Date 2022, June 17).
- Luchevaya terapiya pri rake pryamoi kishki – otzyvy, posledstviya [Radiation therapy for rectal cancer – reviews, consequences]. Available as: https://msassuta.com/otdeleniya/onkologiya-rak-kishechnika-lechenie-raka-pryamoy-kishki/luchevaya-terapiya-pri-rake (Accessed Date 2022, June 17).
- Prilozhenie G4. Shkala otsenki stepeni lechebnogo patomorfoza pri rake zheludka po Mandard. Rak zheludka: klinicheskie rekomendatsii [Annex D4. Scale for assessing the degree of therapeutic pathomorphosis in gastric cancer according to Mandard . Stomach cancer: clinical recommendations]. Available at: https://sudact.ru/law/klinicheskie-rekomendatsii-rak-zheludka-utv-minzdravom-rossii_1/prilozhenie-g/prilozhenie-g4 (Accessed Date 2022, June 17).
- Raikov N.S., Chupin R.N., Popov I.N. et al. Rak pryamoi kishki [Cancer of the rectum]. Tyumenskii meditsinskii zhurnal, 2010, no. 3-4, pp. 75–77.
- Rak pryamoi kishki [Cancer of the rectum]. Available at: https://sechenovclinic.ru/treatments/detail.php?section_id=&element_id=4095 (Accessed Date 2022, June 17).
- Polynovskii A., Kuzmichev D., Mamedli Z. et al. Ekstramural”naya sosudistaya invaziya kak faktor otdalennogo meta-stazirovaniya u bol”nykh mestnorasprostranennym rakom pryamoi kishki [Extramural Vascular Invasion as a Factor of Remote metastasis in Patients with Local Advanced Rectal Cancer]. Voprosy onkologii, 2020, vol. 66, no. 2, pp. 155–159.
About authors
- Ivanova Daria A.
- 4th Year Student of the Medicine Faculty, Chuvash State University, Russia, Cheboksary (dashken690@yandex.ru; ORCID: https://orcid.org/0000-0001-7516-776X)
- Safonova Marina A.
- Candidate of Medical Sciences, Associate Professor, Department of Propaedeutics of Internal Diseases with a Course of Radiology, Chuvash State University; Head of X-ray Diagnostics Department, Republican Clinical Oncology Dispensary, Russia, Cheboksary (safmaran@yandex.ru; ORCID: https://orcid.org/0000-0002-8578-6449)
Article link
Ivanova D.A., Safonova M.A. The Informative Value of Magnetic Resonance Imaging in the Diagnosis of Rectal Tumor Involvement Against the Background of Combined Treatment [Electronic resource] // Acta medica Eurasica. – 2022. – №3. P. 12-19. – URL: https://acta-medica-eurasica.ru/en/single/2022/3/2/. DOI: 10.47026/2413-4864-2022-3-12-19.