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Background: To evaluate the effectiveness of a deep learning denoising approach to accelerate diffusion-weighted imaging (DWI) and thus improve diagnostic accuracy and image quality in restaging rectal MRI following total neoadjuvant therapy (TNT)., Methods: This retrospective single-center study included patients with locally advanced rectal cancer who underwent restaging rectal MRI between December 30, 2021, and June 1, 2022, following TNT. A convolutional neural network trained with DWI data was employed to denoise accelerated DWI acquisitions (i.e., acquisitions performed with a reduced number of repetitions compared to standard acquisitions). Image characteristics and residual disease were independently assessed by two radiologists across original and denoised images. Statistical analyses included the Wilcoxon signed-rank test to compare image quality scores across denoised and original images, weighted kappa statistics for inter-reader agreement assessment, and the calculation of measures of diagnostic accuracy., Results: In 46 patients (median age, 60 years [IQR: 47-72]; 37 men and 9 women), 8- and 16-fold accelerated images maintained or exhibited enhanced lesion visibility and image quality compared with original images that were performed 16 repetitions. Denoised images maintained diagnostic accuracy, with conditional specificities of up to 96 %. Moderate-to-high inter-reader agreement indicated reliable image and diagnostic assessment. The overall test yield for denoised DWI reconstructions ranged from 76-98 %, demonstrating a reduction in equivocal interpretations., Conclusion: Applying a denoising network to accelerate rectal DWI acquisitions can reduce scan times and enhance image quality while maintaining diagnostic accuracy, presenting a potential pathway for more efficient rectal cancer management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Purpose: To evaluate the diagnostic performance of diffusion-weighted imaging (DWI) in the 6-month interval post chemoradiation therapy (CRT) in determining persistent disease and whether persistent diffusion restriction on DWI at 6 months is associated with overall survival; and secondarily, to investigate the accuracy of pelvic lymph node assessment on T2-weighted imaging and DWI in the 6-month interval post CRT, in patients with squamous cell carcinoma of the anus., Methods and Materials: This retrospective study included patients with squamous cell carcinoma of the anus who underwent CRT followed by restaging rectal MRI from January 2010 to April 2020, with ≥1 year of follow-up after CRT. DW images were qualitatively evaluated by 2 junior and 2 senior abdominal radiologists to determine anal persistent disease. The reference standard for anal persistent disease was digital rectal examination/endoscopy and histopathology. Diagnostic performance was estimated using sensitivity, specificity, negative predictive value, and positive predictive value. Survival outcomes were evaluated via Kaplan-Meier analysis, and associations between survival outcomes and DWI status were tested for significance using the log-rank test. Additionally, DW and T2-weighted images were evaluated to determine lymph node status., Results: Among 84 patients (mean age, 63 ± 10.2 years; 64/84 [76%] female), 14 of 84 (17%) had confirmed persistent disease. Interreader agreement on DWI between all 4 radiologists was moderate (Light's κ = 0.553). Overall, DWI had a sensitivity of 71.4%, specificity of 72.1%, positive predictive value of 34.5%, and negative predictive value of 92.5%. Patients with a negative DWI showed better survival than patients with a positive DWI (3-year overall survival of 92% vs 79% and 5-year overall survival of 87% vs 74%), although the difference did not reach statistical significance (P = .063). All patients with suspicious lymph nodes (14/14, 100%) showed negative pathology or decreased size during follow-up., Conclusions: At 6 months post CRT, DWI showed value in excluding anal persistent disease. Persistent diffusion restriction on DWI was not significantly associated with overall survival. Pelvic nodal assessment on DWI and T2-weighted imaging was limited in predicting persistent nodal metastases., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To compare abbreviated magnetic resonance imaging (MRI) to complete MRI for treatment response assessment of colorectal liver metastases.This retrospective study included consecutive patients with colorectal liver metastases between January 1, 2012, and December 3, 2021, who were undergoing chemotherapy and who had at least one follow-up gadoxetic-enhanced MRI. For each patient, two MRIs (baseline MRI and follow-up MRI) were randomly selected. Follow-up MRIs were separated into two sets of images: complete MRIs, including all imaging sequences, and abbreviated MRIs, including coronal and axial hepatobiliary phase imaging, axial diffusion-weighted imaging, and coronal T2-weighted imaging. Seven radiologists reviewed the two sets of images, with a month’s break in between, assessing Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 category and the presence of new lesions, with each reader assigned 80–91 patients. Inter-reader agreement was assessed using Fleiss’ kappa (κ).One-hundred ninety-five patients (mean age 54.4 +/− 12.1 years, 135 men) were evaluated. Intra-reader agreement between abbreviated and complete MRI was substantial for the RECIST 1.1 category (κ, 0.66–0.89) and the detection of new lesions (κ, 0.63–0.81). Inter-reader agreement was substantial for RECIST 1.1 category using abbreviated MRI and complete MRI (κ, 0.71 (95% CI: 0.65–0.78) and 0.68 (95% CI: 0.61–0.75)), and moderate for the presence of new lesions using abbreviated MRI and complete MRI (κ, 0.56 (95% CI: 0.41–0.69) and 0.49 (95% CI: 0.35–0.65)).Abbreviated MRI may serve as an alternative to complete MRI for the follow-up of patients with colorectal liver metastases.QuestionAbbreviated MRI is a time-saving and cost-effective exam, but only one study has compared it with complete MRI for treatment response assessment of colorectal liver metastases.FindingsIn our study, abbreviated follow-up MRI achieved substantial inter-reader agreement for the RECIST 1.1 category and moderate inter-reader agreement for the presence of new lesions.Clinical relevanceAbbreviated liver MRIs are adequate substitutes for complete liver MRIs for colorectal liver metastases in the follow-up setting when the goal is to assess treatment response, resulting in shorter examination times and potential reductions in costs.Material and methods: To compare abbreviated magnetic resonance imaging (MRI) to complete MRI for treatment response assessment of colorectal liver metastases.This retrospective study included consecutive patients with colorectal liver metastases between January 1, 2012, and December 3, 2021, who were undergoing chemotherapy and who had at least one follow-up gadoxetic-enhanced MRI. For each patient, two MRIs (baseline MRI and follow-up MRI) were randomly selected. Follow-up MRIs were separated into two sets of images: complete MRIs, including all imaging sequences, and abbreviated MRIs, including coronal and axial hepatobiliary phase imaging, axial diffusion-weighted imaging, and coronal T2-weighted imaging. Seven radiologists reviewed the two sets of images, with a month’s break in between, assessing Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 category and the presence of new lesions, with each reader assigned 80–91 patients. Inter-reader agreement was assessed using Fleiss’ kappa (κ).One-hundred ninety-five patients (mean age 54.4 +/− 12.1 years, 135 men) were evaluated. Intra-reader agreement between abbreviated and complete MRI was substantial for the RECIST 1.1 category (κ, 0.66–0.89) and the detection of new lesions (κ, 0.63–0.81). Inter-reader agreement was substantial for RECIST 1.1 category using abbreviated MRI and complete MRI (κ, 0.71 (95% CI: 0.65–0.78) and 0.68 (95% CI: 0.61–0.75)), and moderate for the presence of new lesions using abbreviated MRI and complete MRI (κ, 0.56 (95% CI: 0.41–0.69) and 0.49 (95% CI: 0.35–0.65)).Abbreviated MRI may serve as an alternative to complete MRI for the follow-up of patients with colorectal liver metastases.QuestionAbbreviated MRI is a time-saving and cost-effective exam, but only one study has compared it with complete MRI for treatment response assessment of colorectal liver metastases.FindingsIn our study, abbreviated follow-up MRI achieved substantial inter-reader agreement for the RECIST 1.1 category and moderate inter-reader agreement for the presence of new lesions.Clinical relevanceAbbreviated liver MRIs are adequate substitutes for complete liver MRIs for colorectal liver metastases in the follow-up setting when the goal is to assess treatment response, resulting in shorter examination times and potential reductions in costs.Results: To compare abbreviated magnetic resonance imaging (MRI) to complete MRI for treatment response assessment of colorectal liver metastases.This retrospective study included consecutive patients with colorectal liver metastases between January 1, 2012, and December 3, 2021, who were undergoing chemotherapy and who had at least one follow-up gadoxetic-enhanced MRI. For each patient, two MRIs (baseline MRI and follow-up MRI) were randomly selected. Follow-up MRIs were separated into two sets of images: complete MRIs, including all imaging sequences, and abbreviated MRIs, including coronal and axial hepatobiliary phase imaging, axial diffusion-weighted imaging, and coronal T2-weighted imaging. Seven radiologists reviewed the two sets of images, with a month’s break in between, assessing Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 category and the presence of new lesions, with each reader assigned 80–91 patients. Inter-reader agreement was assessed using Fleiss’ kappa (κ).One-hundred ninety-five patients (mean age 54.4 +/− 12.1 years, 135 men) were evaluated. Intra-reader agreement between abbreviated and complete MRI was substantial for the RECIST 1.1 category (κ, 0.66–0.89) and the detection of new lesions (κ, 0.63–0.81). Inter-reader agreement was substantial for RECIST 1.1 category using abbreviated MRI and complete MRI (κ, 0.71 (95% CI: 0.65–0.78) and 0.68 (95% CI: 0.61–0.75)), and moderate for the presence of new lesions using abbreviated MRI and complete MRI (κ, 0.56 (95% CI: 0.41–0.69) and 0.49 (95% CI: 0.35–0.65)).Abbreviated MRI may serve as an alternative to complete MRI for the follow-up of patients with colorectal liver metastases.QuestionAbbreviated MRI is a time-saving and cost-effective exam, but only one study has compared it with complete MRI for treatment response assessment of colorectal liver metastases.FindingsIn our study, abbreviated follow-up MRI achieved substantial inter-reader agreement for the RECIST 1.1 category and moderate inter-reader agreement for the presence of new lesions.Clinical relevanceAbbreviated liver MRIs are adequate substitutes for complete liver MRIs for colorectal liver metastases in the follow-up setting when the goal is to assess treatment response, resulting in shorter examination times and potential reductions in costs.Conclusion: To compare abbreviated magnetic resonance imaging (MRI) to complete MRI for treatment response assessment of colorectal liver metastases.This retrospective study included consecutive patients with colorectal liver metastases between January 1, 2012, and December 3, 2021, who were undergoing chemotherapy and who had at least one follow-up gadoxetic-enhanced MRI. For each patient, two MRIs (baseline MRI and follow-up MRI) were randomly selected. Follow-up MRIs were separated into two sets of images: complete MRIs, including all imaging sequences, and abbreviated MRIs, including coronal and axial hepatobiliary phase imaging, axial diffusion-weighted imaging, and coronal T2-weighted imaging. Seven radiologists reviewed the two sets of images, with a month’s break in between, assessing Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 category and the presence of new lesions, with each reader assigned 80–91 patients. Inter-reader agreement was assessed using Fleiss’ kappa (κ).One-hundred ninety-five patients (mean age 54.4 +/− 12.1 years, 135 men) were evaluated. Intra-reader agreement between abbreviated and complete MRI was substantial for the RECIST 1.1 category (κ, 0.66–0.89) and the detection of new lesions (κ, 0.63–0.81). Inter-reader agreement was substantial for RECIST 1.1 category using abbreviated MRI and complete MRI (κ, 0.71 (95% CI: 0.65–0.78) and 0.68 (95% CI: 0.61–0.75)), and moderate for the presence of new lesions using abbreviated MRI and complete MRI (κ, 0.56 (95% CI: 0.41–0.69) and 0.49 (95% CI: 0.35–0.65)).Abbreviated MRI may serve as an alternative to complete MRI for the follow-up of patients with colorectal liver metastases.QuestionAbbreviated MRI is a time-saving and cost-effective exam, but only one study has compared it with complete MRI for treatment response assessment of colorectal liver metastases.FindingsIn our study, abbreviated follow-up MRI achieved substantial inter-reader agreement for the RECIST 1.1 category and moderate inter-reader agreement for the presence of new lesions.Clinical relevanceAbbreviated liver MRIs are adequate substitutes for complete liver MRIs for colorectal liver metastases in the follow-up setting when the goal is to assess treatment response, resulting in shorter examination times and potential reductions in costs.Key Points: To compare abbreviated magnetic resonance imaging (MRI) to complete MRI for treatment response assessment of colorectal liver metastases.This retrospective study included consecutive patients with colorectal liver metastases between January 1, 2012, and December 3, 2021, who were undergoing chemotherapy and who had at least one follow-up gadoxetic-enhanced MRI. For each patient, two MRIs (baseline MRI and follow-up MRI) were randomly selected. Follow-up MRIs were separated into two sets of images: complete MRIs, including all imaging sequences, and abbreviated MRIs, including coronal and axial hepatobiliary phase imaging, axial diffusion-weighted imaging, and coronal T2-weighted imaging. Seven radiologists reviewed the two sets of images, with a month’s break in between, assessing Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 category and the presence of new lesions, with each reader assigned 80–91 patients. Inter-reader agreement was assessed using Fleiss’ kappa (κ).One-hundred ninety-five patients (mean age 54.4 +/− 12.1 years, 135 men) were evaluated. Intra-reader agreement between abbreviated and complete MRI was substantial for the RECIST 1.1 category (κ, 0.66–0.89) and the detection of new lesions (κ, 0.63–0.81). Inter-reader agreement was substantial for RECIST 1.1 category using abbreviated MRI and complete MRI (κ, 0.71 (95% CI: 0.65–0.78) and 0.68 (95% CI: 0.61–0.75)), and moderate for the presence of new lesions using abbreviated MRI and complete MRI (κ, 0.56 (95% CI: 0.41–0.69) and 0.49 (95% CI: 0.35–0.65)).Abbreviated MRI may serve as an alternative to complete MRI for the follow-up of patients with colorectal liver metastases.QuestionAbbreviated MRI is a time-saving and cost-effective exam, but only one study has compared it with complete MRI for treatment response assessment of colorectal liver metastases.FindingsIn our study, abbreviated follow-up MRI achieved substantial inter-reader agreement for the RECIST 1.1 category and moderate inter-reader agreement for the presence of new lesions.Clinical relevanceAbbreviated liver MRIs are adequate substitutes for complete liver MRIs for colorectal liver metastases in the follow-up setting when the goal is to assess treatment response, resulting in shorter examination times and potential reductions in costs.Graphical Abstract: To compare abbreviated magnetic resonance imaging (MRI) to complete MRI for treatment response assessment of colorectal liver metastases.This retrospective study included consecutive patients with colorectal liver metastases between January 1, 2012, and December 3, 2021, who were undergoing chemotherapy and who had at least one follow-up gadoxetic-enhanced MRI. For each patient, two MRIs (baseline MRI and follow-up MRI) were randomly selected. Follow-up MRIs were separated into two sets of images: complete MRIs, including all imaging sequences, and abbreviated MRIs, including coronal and axial hepatobiliary phase imaging, axial diffusion-weighted imaging, and coronal T2-weighted imaging. Seven radiologists reviewed the two sets of images, with a month’s break in between, assessing Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 category and the presence of new lesions, with each reader assigned 80–91 patients. Inter-reader agreement was assessed using Fleiss’ kappa (κ).One-hundred ninety-five patients (mean age 54.4 +/− 12.1 years, 135 men) were evaluated. Intra-reader agreement between abbreviated and complete MRI was substantial for the RECIST 1.1 category (κ, 0.66–0.89) and the detection of new lesions (κ, 0.63–0.81). Inter-reader agreement was substantial for RECIST 1.1 category using abbreviated MRI and complete MRI (κ, 0.71 (95% CI: 0.65–0.78) and 0.68 (95% CI: 0.61–0.75)), and moderate for the presence of new lesions using abbreviated MRI and complete MRI (κ, 0.56 (95% CI: 0.41–0.69) and 0.49 (95% CI: 0.35–0.65)).Abbreviated MRI may serve as an alternative to complete MRI for the follow-up of patients with colorectal liver metastases.QuestionAbbreviated MRI is a time-saving and cost-effective exam, but only one study has compared it with complete MRI for treatment response assessment of colorectal liver metastases.FindingsIn our study, abbreviated follow-up MRI achieved substantial inter-reader agreement for the RECIST 1.1 category and moderate inter-reader agreement for the presence of new lesions.Clinical relevanceAbbreviated liver MRIs are adequate substitutes for complete liver MRIs for colorectal liver metastases in the follow-up setting when the goal is to assess treatment response, resulting in shorter examination times and potential reductions in costs. 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