{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:52:56Z","timestamp":1789595576438,"version":"build-2803163510"},"reference-count":48,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Oncol Res Treat"],"abstract":"<jats:p>Introduction: Precise prediction of pathological complete response (pCR) following neoadjuvant chemoradiotherapy (nCRT) in rectal cancer may identify candidates for non-operative management. The optimal selection of diagnostic tools is, therefore, of major clinical importance. Methods: Clinical, laboratory, endoscopic, and radiological data of patients with rectal cancer treated with nCRT and surgery at an academic medical center from 2010 to 2020 were retrospectively collected. Pre- and post-nCRT magnetic resonance imaging (MRI) was reviewed with a structured report template and assessed by magnetic resonance imaging tumor regression grade (mrTRG). Two senior radiologists reviewed mrTRG independently to determine the inter-reader agreement. Univariate logistic regression was applied to identify parameters that predict pCR. A multivariate prediction model was developed using L1-penalized logistic regression, with performance assessed by area under the curve (AUC) in the total cohort (apparent AUC) and by cross-validation (CV-AUC). Results: A total of 261 patients were identified, of whom 36 achieved pCR. Univariate analysis showed a significant correlation between post-nCRT features with pCR, including radiological T-stage (odds ratio [OR] 0.05 [0.02\u20130.15], p &lt; 0.001), mrTRG (OR 0.13 [0.05\u20130.31], p &lt; 0.001), and endoscopic response (OR 0.17 [0.05\u20130.54], p = 0.032). Of those, mrTRG showed the highest AUC of 0.77 with a substantial inter-reader agreement (kappa = 0.71, 95% confidence interval: 0.61\u20130.81). The multivariate predictive model selected eight pre- and post-nCRT parameters with an apparent AUC of 0.84 and a CV-AUC of 0.73. Conclusion: Therapy response assessed by MRI, particularly by mrTRG, strongly predicted pCR. Therefore, mrTRG should be implemented in routine assessment of rectal cancer treated by nCRT.<\/jats:p>","DOI":"10.1159\/000548042","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T16:05:47Z","timestamp":1757088347000},"page":"179-191","source":"Crossref","is-referenced-by-count":2,"title":["Structured Magnetic Resonance Imaging Assessment Improves Diagnosis of Pathological Complete Response in Rectal Cancer after Neoadjuvant Chemoradiation"],"prefix":"10.1159","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5960-9350","authenticated-orcid":false,"given":"Moying","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Dieckmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Herrle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf-Dieter","family":"Hofheinz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hielscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Hertel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Schweitzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Hetjens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Betge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Belle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Schulte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Rei\u00dffelder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Boda-Heggemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"Dreher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Brochhausen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias 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