Comparison of Transrectal Sonography and Double-Contrast MR Imaging When Staging Rectal Cancer

Fuchsjäger, Michael; Maier, Andrea; Schima, Wolfgang; Zebedin, Eva; Herbst, F.; Mittlböck, Martina; Wrba, Friedrich; Lechner, G

doi:10.2214/ajr.181.2.1810421

Cited by 58 publications

(40 citation statements)

References 30 publications

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“…The field of view is small, and stenotic or rectosigmoid tumours cannot be reached. For example Glaser et al had to withdraw 10% of patients due to stenosis, and Fuchsjäger et al 28% due to high location of the tumour (27,12).…”

Section: Resultsmentioning

confidence: 99%

Local Staging of Rectal Cancer Using the Black Lumen Magnetic Resonance Imaging Technique

et al. 2008

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Background and Aims: the treatment of rectal cancer is comprised of surgery and possible adjuvant therapy depending on the stage of the tumour.t his prospective study evaluates the accuracy of magnetic resonance imaging (mri) in the preoperative staging of rectal cancer using an endorectal and intravenous contrast.Materials and Methods: 37 consecutive patients with rectal cancer were imaged using am ixture of ferumoxsil and methylcellulose endorectally,a nd ag adolinium contrast intravenously.3 3t umours were resected and 4t umours were considered unresectable during operation. the images were reviewed for local staging of the tumours. atumour confined to the rectal wall was classified as an egative finding and at umour invading through muscularis propria as ap ositive finding. the results were correlated with the histopathologic tstage (n =33), or the clinical status (n =4).Results and Conclusions: of 37 cases, 20 (51 %) were true positive, and 11 (28%) were true negative. there were 3 false negative and 3 false positive cases. the sensitivity was 87%, specificity 79%, and diagnostic accuracy 84%. for the non-contrast images the figures were 78%, 79% and 78%, respectively.We consider black lumen magnetic resonance imaging to be auseful method for preoperative local staging of rectal cancer.

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Section: Resultsmentioning

confidence: 99%

Local Staging of Rectal Cancer Using the Black Lumen Magnetic Resonance Imaging Technique

et al. 2008

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“…However, it has limitations for lower rectal tumors and obese patients (16,29,30). In addition, it provided inadequate spatial resolution to identify early infiltration into mesorectal fat (31). 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).…”

Section: Discussionmentioning

confidence: 99%

“…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). However, the FOV is limited within 3 cm around the coil, and as a result the upper rectal tumors, lateral pelvic, and inferior mesenteric nodal involvement cannot be evaluated effectively (20,31).…”

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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“…Все эти наблюдения отнесены к полному патологическому регрессу опухоли. Именно этот факт, по данным многих исследований, и определя-ет лучший результат комбинированного лечения у боль-ных раком прямой кишки [11,20,21]. В настоящее время хорошо известно, что определение характера регресса опухоли после химиолучевой терапии затруднительно и неточно, поэтому многие авторы предпочитают оце-нивать частоту полного клинического регресса опухоли [22,23,24].…”

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“…Наши данные согласуются с результатами исследований M. H. Fuchsjager с соавт. [20] и K. T. Hoffmann с соавт. [25], которые сообщают об аналогичной оценке степени ин-вазии кишечной стенки и определении наличия метас-тазов в лимфатических узлах.…”

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Multidisciplinary Approach in the Treatment of Patients With Rectal Cancer

Правосудов¹

2015

Zlokač. opuholi

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Хирургический метод является «золотым стандартом» в лечении больных раком прямой кишки. Целью хирургического лечения является сведение к минимуму частоты местных рецидивов, возникновение которых во многом зависит от качества операций. Краеугольным камнем в выборе лечебной тактики следует считать отношение опухоли к собственной фасции прямой кишки. Даже приме-няя современные хирургические методики, большинство опухолей прямой кишки ниже переходной складки брюшины следовало бы ле-чить используя предоперационную лучевую терапию. Предоперационная лучевая (х/л) терапия позволяет уменьшить частоту местных ре-цидивов и создать условия для увеличения числа сфинктеросохранающих операций. Степень регресса опухоли после химиолучевой терапии напрямую коррелирует с выживаемостью и частотой местных рецидивов. Регресс опухоли создает предпосылки для избавления больного с опухолью прямой кишки от послеоперационных осложнений и летальности, связанных с выполнением обширных радикальных операций. Использование стандартизированных систем для оценки степени регресса опухоли может предоставить ценную информацию центрам, специлизирующимся на лечении больных с данной патологией. МРТ малого таза является весьма эффективным инструментом в первичной оценке степени местнорегионарного распространения рака прямой кишки, включая отношение к мезоректальной фасции. Сложности в прогнозировании полного патологического регресса опухоли с помощью МРТ связаны, прежде всего, с проблемой диффе-ренциальной диагностики между постлучевыми и опухолевыми изменениями кишечной стенки и окружающих тканей. Мультидисциплинарный подход обеспечивает точность стадирования и способствует выработке оптимальной лечебной тактики у больных раком прямой кишки.Ключевые слова: рак прямой кишки, МРТ, химиолучевая терапия, полный клинический ответ, мультидисциплинарный подход.

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Comparison of Transrectal Sonography and Double-Contrast MR Imaging When Staging Rectal Cancer

Cited by 58 publications

References 30 publications

Local Staging of Rectal Cancer Using the Black Lumen Magnetic Resonance Imaging Technique

Local Staging of Rectal Cancer Using the Black Lumen Magnetic Resonance Imaging Technique

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

Multidisciplinary Approach in the Treatment of Patients With Rectal Cancer

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