Assessment of rectal tumor infiltration utilizing endorectal MR imaging and comparison with endoscopic rectal sonography

Zagoria, Ronald J.; Schlarb, Christopher A.; Ott, David J.; Bechtold, Robert E.; Wolfman, Neil T.; Scharling, Eric S.; Chen, Michael Y. M.; Loggie, Brian W.

doi:10.1002/(sici)1096-9098(199704)64:4<312::aid-jso12>3.0.co;2-4

Cited by 78 publications

(27 citation statements)

References 16 publications

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“…In previous studies similar results were found when comparing body-coil MR and TRUS in 30 patients [17], endorectal MR and TRUS in 10 patients [15], in 21 patients [28] and combined use of double surface coil and endorectal MR and TRUS in 15 patients [29]. In one of these studies [17], MR was found to be slightly better than TRUS in determining tumour invasion into adjacent organs.…”

Section: Discussionsupporting

confidence: 70%

“…In rectal cancer staging, both transrectal ultrasonography (TRUS), CT and MR imaging have all been evaluated for assessing both tumour infiltration in the bowel wall and loco-regional lymph node metastases [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]. Despite initial promising results and subsequent technical developments of the methods, the overall results in large series of patients indicate that presently routine staging of rectal cancer cannot be justified, because the accuracy to predict tumour penetration and lymph node metastases is limited [22,23,24,25].…”

Section: Introductionmentioning

confidence: 99%

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Rectal tumour staging: MR imaging using pelvic phased-array and endorectal coils vs endoscopic ultrasonography

et al. 2000

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The aim of this study was to compare MR imaging and endoscopic ultrasonography (EUS) for the local staging of rectal tumours. Forty-nine patients were examined on a 1.5-T MR unit using either a pelvic phased-array coil (n = 37) alone or combined with an endorectal coil (n = 12). Sagittal and axial sequences with T2-weighted fast spin-echo and axial T1-weighted spin-echo techniques were employed. The EUS technique was performed using a flexible endosonoscope. The results were compared with findings at histopathological sectioning of the specimen. The T-stage on MR correlated with histopathology in 32 of 49 patients and on EUS in 29 of 49 patients. The N-stage on MR correlated with histopathology in 22 of 49 patients and on EUS in 26 of 49 patients. Tumour penetration of the rectal wall was predicted by MR with 86 % sensitivity and 65 % specificity, and by EUS with 89% sensitivity and 33% specificity. Preoperative radiotherapy was administered to 40 of the patients after the examinations which may explain some of the overstaging by MR and EUS. Three patients with surgically and histopathologically confirmed invasion of neighbouring organs in the pelvis were detected preoperatively on MR but none on EUS. Tumour penetration of the rectal wall and local lymph node metastases cannot accurately be predicted with MR or EUS. Magnetic resonance, however, seems to be more useful for preoperative identification of clinically occult advanced disease.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Rectal tumour staging: MR imaging using pelvic phased-array and endorectal coils vs endoscopic ultrasonography

et al. 2000

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“…An endorectal coil provides a high SNR and therefore can be used to discriminate individual layers of the rectal wall and differentiate the muscularis propria from the submucosa and mesorectal fat (17). As a result, endorectal-coil MRI has been shown to have higher T-stage accuracy, ranging from 71% to 85% (17)(18)(19)(20)(21). Moreover, excellent depiction of sphincter infiltration in lower rectal tumors can be achieved (31).…”

Section: Discussionmentioning

confidence: 99%

Local staging of rectal cancer using combined pelvic phased‐array and endorectal coil MRI

Tatlı

Mortelé

Breen

et al. 2006

Magnetic Resonance Imaging

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Purpose:To assess the accuracy of MRI, using a pelvic phased-array coil and an endorectal coil, for preoperative local staging of rectal cancer. Materials and Methods:Fifty-one patients (26 males and 25 females) with adenocarcinoma of the rectum underwent preoperative MRI and surgical resection of their tumors. Surgical pathology staging was compared to MRI staging (using the TNM classification) obtained both retrospectively by a reader blinded to surgical findings and prospectively (radiological reports). In addition, patients were stratified according to surgical treatment groups (stage I ϭ T1-2/N0, stage II ϭ T3/N0, stage III ϭ Tx/N1-2).Results: At pathology, 36 of 51 (68%) tumors were classified as T0-T2, and 15 (32%) were classified as T3. Overall, the sensitivity and specificity of MRI readings for T3 staging were 93% and 86%, respectively (positive predictive value (PPV) ϭ 74%, negative predictive value (NPV) ϭ 97%, accuracy ϭ 88%). MRI correctly predicted lymph node metastases in 11 of 13 patients with a sensitivity of 85% and specificity of 69% (PPV ϭ 58%, NPV ϭ 90%, accuracy ϭ 74%). MRI correctly predicted surgical treatment groups in 33 of 39 (85%) patients. Interobserver agreement between the retrospective and prospective readings was excellent ( ϭ 0.85) for prediction of T3 tumor and good ( ϭ 0.80) for prediction of nodal involvement. Conclusion:Combined endorectal and pelvic phased-array coil MRI can be used reliably to select which patients should receive preoperative chemoradiotherapy. It is highly predictive in terms of excluding T3 tumors, but still has limitations in predicting lymph node metastasis.

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“…Similarly, the utilization of a rectal balloon with MR imaging has been reported to facilitate visualization of the bowel wall strata, demonstrating an 88% accuracy for detecting muscularis propria invasion (T2) and 79% accuracy for staging T3 lesions [19]. Two recent studies using ERSCMRI found it to be 80% and 86 -89% accurate in T-staging for rectal tumors [20,21]. One of these studies compared the results with corresponding EUS imaging in 10 patients and found T-stage accuracies to be 80% and 70% accurate, respectively, but found no statistically significant difference between the two modalities [20].…”

Section: Discussionmentioning

confidence: 99%

“…Two recent studies using ERSCMRI found it to be 80% and 86 -89% accurate in T-staging for rectal tumors [20,21]. One of these studies compared the results with corresponding EUS imaging in 10 patients and found T-stage accuracies to be 80% and 70% accurate, respectively, but found no statistically significant difference between the two modalities [20].…”

Section: Discussionmentioning

confidence: 99%

Endorectal surface coil MR imaging as a staging technique for rectal carcinoma: a comparison study to rectal endosonography

et al. 2000

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Assessment of rectal tumor infiltration utilizing endorectal MR imaging and comparison with endoscopic rectal sonography

Cited by 78 publications

References 16 publications

Rectal tumour staging: MR imaging using pelvic phased-array and endorectal coils vs endoscopic ultrasonography

Rectal tumour staging: MR imaging using pelvic phased-array and endorectal coils vs endoscopic ultrasonography

Local staging of rectal cancer using combined pelvic phased‐array and endorectal coil MRI

Endorectal surface coil MR imaging as a staging technique for rectal carcinoma: a comparison study to rectal endosonography

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