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Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting.

ABSTRACT: OBJECTIVES:To update the 2012 ESGAR consensus guidelines on the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer. METHODS:Fourteen abdominal imaging experts from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) participated in a consensus meeting, organised according to an adaptation of the RAND-UCLA Appropriateness Method. Two independent (non-voting) Chairs facilitated the meeting. 246 items were scored (comprising 229 items from the previous 2012 consensus and 17 additional items) and classified as 'appropriate' or 'inappropriate' (defined by ? 80 % consensus) or uncertain (defined by

SUBMITTER: Beets-Tan RGH

PROVIDER: S-EPMC5834554 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting.

Beets-Tan Regina G H RGH Lambregts Doenja M J DMJ Maas Monique M Bipat Shandra S Barbaro Brunella B Curvo-Semedo Luís L Fenlon Helen M HM Gollub Marc J MJ Gourtsoyianni Sofia S Halligan Steve S Hoeffel Christine C Kim Seung Ho SH Laghi Andrea A Maier Andrea A Rafaelsen Søren R SR Stoker Jaap J Taylor Stuart A SA Torkzad Michael R MR Blomqvist Lennart L

European radiology 20171017 4

<h4>Objectives</h4>To update the 2012 ESGAR consensus guidelines on the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer.<h4>Methods</h4>Fourteen abdominal imaging experts from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) participated in a consensus meeting, organised according to an adaptation of the RAND-UCLA Appropriateness Method. Two independent (non-voting) Chairs facilitated the me ...[more]

PMID: 29043428

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Project description:PurposeTo update the World Society of the Abdominal Compartment Syndrome (WSACS) consensus definitions and management statements relating to intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS).MethodsWe conducted systematic or structured reviews to identify relevant studies relating to IAH or ACS. Updated consensus definitions and management statements were then derived using a modified Delphi method and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines, respectively. Quality of evidence was graded from high (A) to very low (D) and management statements from strong RECOMMENDATIONS (desirable effects clearly outweigh potential undesirable ones) to weaker SUGGESTIONS (potential risks and benefits of the intervention are less clear).ResultsIn addition to reviewing the consensus definitions proposed in 2006, the WSACS defined the open abdomen, lateralization of the abdominal musculature, polycompartment syndrome, and abdominal compliance, and proposed an open abdomen classification system. RECOMMENDATIONS included intra-abdominal pressure (IAP) measurement, avoidance of sustained IAH, protocolized IAP monitoring and management, decompressive laparotomy for overt ACS, and negative pressure wound therapy and efforts to achieve same-hospital-stay fascial closure among patients with an open abdomen. SUGGESTIONS included use of medical therapies and percutaneous catheter drainage for treatment of IAH/ACS, considering the association between body position and IAP, attempts to avoid a positive fluid balance after initial patient resuscitation, use of enhanced ratios of plasma to red blood cells and prophylactic open abdominal strategies, and avoidance of routine early biologic mesh use among patients with open abdominal wounds. NO RECOMMENDATIONS were possible regarding monitoring of abdominal perfusion pressure or the use of diuretics, renal replacement therapies, albumin, or acute component-parts separation.ConclusionAlthough IAH and ACS are common and frequently associated with poor outcomes, the overall quality of evidence available to guide development of RECOMMENDATIONS was generally low. Appropriately designed intervention trials are urgently needed for patients with IAH and ACS.

Project description:BackgroundMaterial presented at conferences is meant to provide exposure to ongoing research that could affect medical decision making based on future outcomes. It is important then to evaluate the rates of publication from conference presentations as a measure of academic quality as such research has undergone peer review and journal acceptance. The purpose of this study is to evaluate the fate of abstracts presented at the Skeletal Society of Radiology Annual Meetings from 2010-2015.Materials and methodsConference abstracts were searched using Google, Google Scholar, and PubMed (which includes Medline) to locate the corresponding published reports. The data recorded for published studies included date published online, in print, or both; the journal in which it was published; and the 5-year journal impact factor. When an abstract was not confirmed as published, authors were contacted by email to verify its publication status or, if not published, the reason for nonpublication.ResultsA total of 162 abstracts were published out of 320 presented (50.6%) at the SSR conferences from 2010 to 2015 with 59.9% (85/142) of publications occurring within two years of the conference date (not counting abstracts published prior to conference). Mean time to publication was 19 months and is calculated by excluding the 20 (12.3%) abstracts that were published prior to the conference date. The median time to publication is 13 months (25th-75th percentile: 6.25-21.75). The top two journals publishing research studies from this conference were Skeletal Radiology and The American Journal of Roentgenology. These journals accepted 72 of the 162 (44.4%) studies for publication. Of the 14 authors who responded with 17 reasons for not publishing, the most common reasons were lack of time (7-41.2%), results not important enough (4-23.5%), publication not an aim (3-17.6%), and lack of resources (3-17.6%).DiscussionAt least half of the abstracts presented at the annual meeting for the Society of Skeletal Radiology are accepted for publication in a peer-reviewed journal. The majority (59.9%) of these publications were achieved within two years of the conference presentation. The rate at which presentations are published and the journals that accept the abstracts can potentially be used to compare the importance and quality of information at conferences.

Project description:ObjectiveTo provide an evidence-based guide for the MRI interpretation of complete tumor response after neoadjuvant chemoradiation therapy (CRT) for rectal cancer using visual assessment on T2-weighted imaging (T2) and diffusion-weighted imaging (DWI).Materials and methodsPubMed MEDLINE, EMBASE, and Cochrane Library were searched on November 28, 2019 to identify articles on the following issues: 1) sensitivity and specificity of T2 or DWI for diagnosing pathologic complete response (pCR) and the criteria for MRI diagnosis; 2) MRI alone vs. MRI combined with other test(s) in sensitivity and specificity for pCR; and 3) tests to select patients for the watch-and-wait management. Eligible articles were selected according to meticulous criteria and were synthesized.ResultsOf 1615 article candidates, 55 eligible articles (for all three issues combined) were identified. Combined T2 and DWI performed better than T2 alone, with a meta-analytic summary sensitivity of 0.62 (95% confidence interval [CI], 0.43-0.77; I² = 80.60) and summary specificity of 0.89 (95% CI, 0.80-0.94; I² = 92.61) for diagnosing pCR. The criteria for the complete response on T2 in most studies had the commonality of remarkable tumor decrease to the absence of mass-like or nodular intermediate signal, although somewhat varied, as follows: (near) normalization of the wall; regular, thin, hypointense scar in the luminal side with (near) normal-appearance or homogeneous intermediate signal in the underlying wall; and hypointense thickening of the wall. The criteria on DWI were the absence of a hyperintense signal at high b-value (? 800 sec/mm²) in most studies. The specific algorithm to combine T2 and DWI was obscure in half of the studies. MRI combined with endoscopy was the most utilized means to select patients for the watch-and-wait management despite a lack of strong evidence to guide and support a multi-test approach.ConclusionThis systematic review and meta-analysis provide an evidence-based practical guide for MRI assessment of complete tumor response after CRT for rectal cancer.

Dataset Information

Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting.

Publications

Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting.

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