Elastography and diffusion-weighted MRI in patients with rectal cancer

Rafaelsen, Søren Rafael; Vagn-Hansen, Chris Aksel; Sørensen, Torben; Lindebjerg, Jan; Pløen, John; Jakobsen, Anders

doi:10.1259/bjr.20150294

Cited by 11 publications

(10 citation statements)

References 25 publications

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“…Thus, SE may improve the staging of rectal cancer and differentiate adenoma from adenocarcinoma, when compared to ERUS alone and with MR imaging (with high interobserver agreement of recorded videos and images) [226 -228]. Another group found good correlation between diffusion-weighted MR imaging which is associated with fibrosis, and SWE of malignant rectal tumors [229]. Another study assessed the performance of ERUS for rectal tumors using SWE using an 8 MHz endorectal transducer, finding that the tumor stiffness measurements corresponded accurately to the pathological tumor T-stage and diagnostic accuracy of tumor staging improved from 76.7 % to 93.3 % [230].…”

Section: Characterization and Staging Of Rectal Tumorsmentioning

confidence: 99%

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018

et al. 2019

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Section: Characterization and Staging Of Rectal Tumorsmentioning

confidence: 99%

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018

et al. 2019

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“…The principle of ultrasound elastography assessment of rectal tumors is the change in tumor hardness caused by malignant transformation. There are multiple elastography methods, but to date only strain elastography (quasi static elastography) has been tested for the endoluminal staging of rectal tumors, although point shear wave elastography has shown promise using the transperineal approach 17 18 . Strain elastography enables visualization and semi-quantification of tissue elasticity by generating a color-coded map which is superimposed onto a B-mode image.…”

Section: Endorectal Ultrasoundmentioning

confidence: 99%

EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound

Nuernberg

Săftoiu

Barreiros

et al. 2019

Ultrasound Int Open

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This article represents part 3 of the EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound (GIUS). It provides an overview of the examination techniques recommended by experts in the field of endorectal/endoanal ultrasound (ERUS/EAUS), as well as perineal ultrasound (PNUS). The most important indications are rectal tumors and inflammatory diseases like fistula and abscesses in patients with or without inflammatory bowel disease (IBD). PNUS sometimes is more flexible and convenient compared to ERUS. However, the technique of ERUS is quite well established, especially for the staging of rectal cancer. EAUS also gained ground in the evaluation of perianal diseases like fistulas, abscesses and incontinence. For the staging of perirectal tumors, the use of PNUS in addition to conventional ERUS could be recommended. For the staging of anal carcinomas, PNUS can be a good option because of the higher resolution. Both ERUS and PNUS are considered excellent guidance methods for invasive interventions, such as the drainage of fluids or targeted biopsy of tissue lesions. For abscess detection and evaluation, contrast-enhanced ultrasound (CEUS) also helps in therapy planning.

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“…Rectal cancer is often stiffer than the normal intestinal wall, but rectal adenoma is a soft mass (23). The technologies of US elastography, such as strain imaging and shear-wave elastography (SWE), have been introduced to assess tissue stiffness noninvasively (24)(25)(26). One of the important advantages of SWE over endorectal US is that SWE is a quantitative evaluation of the lesion elasticity in kilopascals or meters per second, whereas endorectal US is qualitative.…”

Section: Patientsmentioning

confidence: 99%

Assessment of Rectal Tumors with Shear-Wave Elastography before Surgery: Comparison with Endorectal US

Chen

Wang

et al. 2017

Radiology

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Purpose To compare the value of endorectal ultrasonography (US) with shear-wave elastography (SWE) in staging rectal tumors before surgery. Materials and Methods This prospective study was approved by the institutional review board and written informed consent was obtained. In a pilot cohort from April 2015 to January 2016, 70 patients with rectal adenocarcinomas and/or adenomas confirmed with histopathologic examination underwent both endorectal US and SWE. Tumor stiffness and three regions of reference backgrounds, as well as tumor stiffness ratios (SRs) versus these backgrounds, were analyzed. The optimal staging feature was selected by using receiver operating characteristic analysis, and the concordance rate with pathologic stage was analyzed and compared with endorectal US. The results were validated in an independent cohort of 30 patients from February 2016 to July 2016. Results In the pilot study, from rectal adenoma to stage T3 cancers, the tumor stiffness, stiffness of peritumoral fat, tumor SR versus distant perirectal fat, and tumor SR versus normal rectal wall were significantly increased (all P < .05, correlation coefficients between SWE features and pathologic T stages were 0.589-0.853). Receiver operating characteristic analysis of tumor staging demonstrated that tumor stiffness was the optimal feature with the highest area under the receiver operating characteristic curve (AUC = 0.991-1.000). The cutoff values of stage T1, T2, and T3 cancers were 26.9 kPa, 70.3 kPa, and 112.0 kPa, respectively. For SWE, the diagnostic concordance rate with pathologic stage (95.7%, weighted κ = 0.962) was higher than that of endorectal US (75.7%, weighted κ = 0.756). In the validation cohort, similar findings were revealed for diagnostic concordance rate (93.3% vs 76.7%; weighted κ = 0.927 vs 0.651) and diagnostic performance of tumor staging (AUC = 0.950-1.000 vs 0.700-0.833). Conclusion By using the feature of tumor stiffness at SWE, the accuracy of preoperative staging for rectal tumors was improved compared with endorectal US in the pilot study, but was not significantly different in the validation cohort, potentially due to small sample size. RSNA, 2017 Online supplemental material is available for this article.

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Elastography and diffusion-weighted MRI in patients with rectal cancer

Cited by 11 publications

References 25 publications

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018

EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound

Assessment of Rectal Tumors with Shear-Wave Elastography before Surgery: Comparison with Endorectal US

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