{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:55:24Z","timestamp":1777434924356,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Norwegian society of medical Radiology","award":["\u201cAstrid og Finn Busch-Arnessens legat\u201d in 2015"],"award-info":[{"award-number":["\u201cAstrid og Finn Busch-Arnessens legat\u201d in 2015"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Acta Radiologica Open"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In staging early rectal cancers (ERC), submucosal tumor depth is one of the most important features determining the possibility of local excision (LE). The micro-enema (Bisacodyl) induces submucosal edema and may hypothetically improve the visualization of tumor depth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To test the diagnostic performance of MRI to identify ERC suitable for LE when adding a pre-procedural micro-enema and concurrent use of a modified classification system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>In this prospective study, we consecutively included 73 patients with newly diagnosed rectal tumors. Two experienced radiologists independently interpreted the MRI examinations, and diagnostic performance was calculated for local tumors eligible for LE (Tis-T1sm2, n = 43) and non-local tumors too advanced for LE (T1sm3-T3b, n = 30). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were registered for each reader. Inter- and intra-reader agreements were assessed by kappa statistics. Lymph node status was derived from the clinical MRI reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Reader1\/reader2 achieved sensitivities of 93%\/86%, specificities of 90%\/83%, PPV of 93%\/88%, and NPV of 90%\/81%, respectively, for identifying tumors eligible for LE. Rates of overstaging of local tumors were 7% and 14% for the two readers, and kappa values for the inter- and intra-reader agreement were 0.69 and 0.80, respectively. For tumors \u2264T2, all metastatic lymph nodes were smaller than 3\u00a0mm on histopathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MRI after a rectal micro-enema and concurrent use of a modified staging system achieved good diagnostic performance to identify tumors suitable for LE. The rate of overstaging of local tumors was comparable to results reported in previous endorectal ultrasound (ERUS) studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20584601241241523","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T10:49:50Z","timestamp":1713437390000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Early rectal cancer: The diagnostic performance of MRI supplemented with a rectal micro-enema and a modified staging system to identify tumors eligible for local excision"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7140-2440","authenticated-orcid":false,"given":"Ellen","family":"Viktil","sequence":"first","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Oslo University Hospital \u2013 Ullev\u00e5l Hospital, Oslo, Norway"},{"name":"Institution of Clinical Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bettina Andrea","family":"Hanekamp","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Oslo University Hospital \u2013 Ullev\u00e5l Hospital, Oslo, Norway"},{"name":"Institution of Clinical Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arild","family":"Nesbakken","sequence":"additional","affiliation":[{"name":"Institution of Clinical Medicine, University of Oslo, Oslo, Norway"},{"name":"Department of Gastrointestinal Surgery, Oslo University Hospital \u2013 Ullev\u00e5l Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Else Marit","family":"L\u00f8berg","sequence":"additional","affiliation":[{"name":"Institution of Clinical Medicine, University of Oslo, Oslo, Norway"},{"name":"Department of Pathology, Oslo University Hospital \u2013 Ullev\u00e5l Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole Helmer","family":"Sjo","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Oslo University Hospital \u2013 Ullev\u00e5l Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Neg\u00e5rd","sequence":"additional","affiliation":[{"name":"Institution of Clinical Medicine, University of Oslo, Oslo, Norway"},{"name":"Department of Radiology, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johann Baptist","family":"Dormagen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Oslo University Hospital \u2013 Ullev\u00e5l Hospital, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7406-5497","authenticated-orcid":false,"given":"Anselm","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Oslo University Hospital \u2013 Ullev\u00e5l Hospital, Oslo, Norway"},{"name":"Institution of Clinical Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"key":"bibr1-20584601241241523","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4067-3"},{"key":"bibr2-20584601241241523","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-017-5026-2"},{"key":"bibr3-20584601241241523","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-0231-5"},{"key":"bibr4-20584601241241523","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15015"},{"key":"bibr5-20584601241241523","doi-asserted-by":"publisher","DOI":"10.1007\/BF02049154"},{"key":"bibr6-20584601241241523","volume-title":"UICC TNM classification of malignant tumours","author":"Brierly JD","year":"2016","edition":"8"},{"key":"bibr7-20584601241241523","unstructured":"Helsedirektoratet. 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