{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:00:18Z","timestamp":1792144818675,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T00:00:00Z","timestamp":1691280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this work was to investigate the value of rectal cancer T\u2010staging on MRI after chemoradiotherapy (ymrT\u2010staging) in relation to the degree of fibrotic transformation of the tumour bed as assessed using the pathological tumour regression grade (pTRG) of Mandard as a standard of reference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Twenty two radiologists, including five rectal MRI experts and 17 \u2018nonexperts\u2019 (general\/abdominal radiologists), evaluated the ymrT stage on the restaging MRIs of 90 rectal cancer patients after chemoradiotherapy. The ymrT stage was compared with the final ypT stage at histopathology; the percentages of correct staging (ymrT\u2009=\u2009ypT), understaging (ymrT\u2009&lt;\u2009ypT) and overstaging (ymrT\u2009&gt;\u2009ypT) were calculated and compared between patients with predominant tumour at histopathology (pTRG4\u20135) and patients with predominant fibrosis (pTRG1\u20133). Interobserver agreement (IOA) was computed using Krippendorff's alpha.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Average ymrT\/ypT stage concordance was 48% for the experts and 43% for the nonexperts; ymrT\/ypT stage concordance was significantly higher in the pTRG4\u20135 subgroup (58% vs. 41% for the pTRG1\u20133 group; <jats:italic>p<\/jats:italic>\u2009=\u20090.01), with the best results for the MRI experts. Overstaging was the main source of error, especially in the pTRG1\u20133 subgroup (average overstaging rate 38%\u201344% vs. 13%\u201355% in the pTRG4\u20135 subgroup). IOA was higher for the expert versus nonexpert readers (\u03b1\u2009=\u20090.67 vs. \u03b1\u2009=\u20090.39).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ymrT\u2010staging is moderately accurate; accuracy is higher in poorly responding patients with predominant tumour but low in good responders with predominant fibrosis, resulting in significant overstaging. Radiologists should shift their focus from ymrT\u2010staging to detecting gross residual (and progressive) disease, and identifying potential candidates for organ preservation who would benefit from further clinical and endoscopic evaluation to guide final treatment planning.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16698","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T05:54:40Z","timestamp":1691387680000},"page":"1878-1887","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Sense and nonsense of <scp>yT<\/scp>\u2010staging on <scp>MRI<\/scp> after chemoradiotherapy in rectal cancer"],"prefix":"10.1111","volume":"25","author":[{"given":"Najim","family":"El\u00a0Khababi","sequence":"first","affiliation":[{"name":"Department of Radiology The Netherlands Cancer Institute  Amsterdam The Netherlands"},{"name":"GROW School for Oncology and Reproduction University of Maastricht  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina G. H.","family":"Beets\u2010Tan","sequence":"additional","affiliation":[{"name":"Department of Radiology The Netherlands Cancer Institute  Amsterdam The Netherlands"},{"name":"GROW School for Oncology and Reproduction University of Maastricht  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Tissier","sequence":"additional","affiliation":[{"name":"Biostatistics Unit The Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max J.","family":"Lahaye","sequence":"additional","affiliation":[{"name":"Department of Radiology The Netherlands Cancer Institute  Amsterdam The Netherlands"},{"name":"GROW School for Oncology and Reproduction University of Maastricht  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Maas","sequence":"additional","affiliation":[{"name":"Department of Radiology The Netherlands Cancer Institute  Amsterdam The Netherlands"},{"name":"GROW School for Oncology and Reproduction University of Maastricht  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00eds","family":"Curvo\u2010Semedo","sequence":"additional","affiliation":[{"name":"Department of Radiology Centro Hospitalar e Universitario de Coimbra EPE Faculty of Medicine, University of Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rapha\u00ebla C.","family":"Dresen","sequence":"additional","affiliation":[{"name":"Department of Radiology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Nougaret","sequence":"additional","affiliation":[{"name":"Medical Imaging Department Montpellier Cancer Institute, Montpellier Cancer Research Institute (U1194), University of Montpellier  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1671-9912","authenticated-orcid":false,"given":"Geerard L.","family":"Beets","sequence":"additional","affiliation":[{"name":"GROW School for Oncology and Reproduction University of Maastricht  Maastricht The Netherlands"},{"name":"Department of Surgery The Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doenja M. J.","family":"Lambregts","sequence":"additional","affiliation":[{"name":"Department of Radiology The Netherlands Cancer Institute  Amsterdam The Netherlands"},{"name":"GROW School for Oncology and Reproduction University of Maastricht  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Rectal MRI Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2020.02.001"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-017-5026-2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-021-03007-w"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261\u2010021\u201003279\u20102"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-018-1642-9"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2018.0611"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.34.9068"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001321"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4687-9"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(18)31078\u2010X"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(19)30410-8"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.13122833"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2022.101739"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-021-08251-8"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261\u2010021\u201003281\u20108"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2016.05.005"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(19940601)73:11<2680::aid\u2010cncr2820731105>3.0.co;2\u2010c"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000022"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000915"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-019-06348-9"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.16.17242"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-08334-8"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2020.101964"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000743"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2017.320"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12976"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2309-3"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20180655"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.16698","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T19:29:16Z","timestamp":1700681356000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.16698"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,6]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1111\/codi.16698"],"URL":"https:\/\/doi.org\/10.1111\/codi.16698","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,6]]},"assertion":[{"value":"2022-11-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}