Endorectal elastography in the evaluation of rectal tumours

Waage, Jo Erling Riise; Havre, Roald Flesland; Ødegaard, Svein; Leh, Sabine; Eide, Geir Egil; Baatrup, Gunnar

doi:10.1111/j.1463-1318.2010.02440.x

Cited by 52 publications

(62 citation statements)

References 28 publications

(37 reference statements)

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“…Waage et al [3] studied a series of patients using an endorectal probe. Elastography presented a diagnostic accuracy of about 94 % in differentiating rectal adenomas (n = 23) from rectal carcinomas (n = 45).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of one small bowel tumor: the role of conventional ultrasound and elastography

et al. 2014

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Neuroendocrine tumors are the most common primary tumors of the small bowel, but diagnosis is usually delayed as the lesions are small and symptoms are mild or nonspecific. Diagnosis of this disease is currently based on radiologic or endoscopic findings. Ultrasound (US) is used as a first-line examination in patients with abdominal symptoms, as this technique permits an overall view of the gastrointestinal tract providing diagnosis of inflammatory and/or neoplastic disorders in a large proportion of patients. The aim of this case report is to describe the feasibility and diagnostic accuracy of elastography in the diagnosis of a tumor of the ileum. The patient underwent conventional gray-scale US and elastography before surgery and these examinations were repeated postoperatively on the surgical specimen confirming preoperative outcome.Keywords Tumor Á Neuroendocrine tumors Á Small bowel Á Ultrasound Riassunto Il tumore neuroendocrino, tra le neoplasie primitive dell'intestino tenue, è il più frequente, la diagnosi è usualmente tardiva per le piccole dimensioni e per la sintomatologia lieve, poco specifica. La diagnosi di questa forma morbosa si basa attualmente su metodiche radiologiche o endoscopiche. L'ecografia è indagine di primo livello in soggetti con sintomatologia addominale ed in una percentuale di soggetti permette anche lo studio del tubo digerente e la diagnosi di patologie neoplastiche o infiammatorie. Scopo del lavoro è di descrivere l'utilità della elastografia nella diagnosi di un tumore dell'ileo in cui l'esame ecografico convenzionale ed elastografico sono stati effettuati sul paziente prima dell'intervento chirurgico e successivamente sul pezzo operatorio con conferma dei riscontri precedenti all'intervento.

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Section: Discussionmentioning

confidence: 99%

Diagnosis of one small bowel tumor: the role of conventional ultrasound and elastography

et al. 2014

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“…Elastography can distinguish malignant form benign tumors (malignant tumor mean strain ratio value over 1.25 and benign tumor mean strain ratio value below 1.25 [4]. In terms of cancer staging, elastography, along with TRUS, is useful to distinguish pT0 stage from pT1 stage, with better results than MRI, including pretreatment biopsy.…”

Section: Cross-sectional Imaging Techniquesmentioning

confidence: 99%

“…Among these, endoscopic ultrasound has proven to be the best imaging technique in rectal tumors. A complete endoscopic ultrasound multimodal examination may even surpass biopsy in terms of rectal cancer detection [3,4] Ultrasound techniques 2D and 3D gray scale ultrasound. Endorectal and endovaginal US, in one term endoscopic US, represent the essential test for the local assessment of rectal tu-mors.…”

Section: Introductionmentioning

confidence: 99%

Characterization and staging of rectal tumors: endoscopic ultrasound versus MRI / CT. Pictorial essay.

et al. 2015

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Endoscopic ultrasound is recommended for rectal cancer staging. Transrectal ultrasound approach is able to overcome one of the limitations of this technique regarding circumferential rectal stenosis. Prior intrarectal administration of a small amount of fluid contrast agent optimizes the method, making it easier to distinguish the layers of the rectal wall and tumor formation. Endoscopic ultrasound focuses on the gray-scale mode. Additional procedures provide useful information for tumor assessment: Doppler ultrasound helps identify chaotic intratumoral vascularization; 3D ultrasound allows the assessment and accurate measurement of the tumor; elastography can identify focal tumor dysplasia within adenomas; contrast-enhanced ultrasound allows characterization of tumor microvasculature. Even if they are not as accurate in distinguishing rectal wall layers, cross-sectional imaging techniques (CT, MRI) can identify the anatomical relationships of advanced locoregional cancers, as well as possible distant metastasis. This paper aims at illustrating the main pathological aspects of endoscopic ultrasound multimodal examination useful for cancer staging.

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“…There is hope that the method would help for a better rectal tumor staging and differentiation between adenomas and adenocarcinomas [28]. To identify rectal tumor formations, Waage et al have used the Hitachi equipment with a micro-convex endorectal transducer (5-10 MHz), rigid, with 360-degree US scanning [26]. The intermittent compression of rectal formations was achieved using a water balloon which completely covers the transducer, intermittent compression being reproduced by inflating and deflating the balloon.…”

Section: Gray Scale Us (2d 3d)mentioning

confidence: 99%

“…For an accurate calculation of SR, the two regions of interest (ROI) should be positioned at a similar vertical distance from the transducer [25]. Endoscopic color elastography is a real-time method that requires small amplitude intermittent compression in order to obtain a valid image [26]. As the procedure is examiner-dependent, the screen has a quality indicator which needs to be reached for the investigation to be considered correct.…”

Section: Gray Scale Us (2d 3d)mentioning

confidence: 99%

Endoscopic ultrasound for the characterization and staging of rectal cancer. Current state of the method. Technological advances and perspectives.

et al. 2015

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Endoscopic ultrasound is the most accurate type of examination for the assessment of rectal tumors. Over the years, the method has advanced from gray-scale examination to intravenous contrast media administration and to different types of elastography. The multimodal approach of tumors (transrectal, transvaginal) is adapted to each case. 3D ultrasound is useful for spatial representation and precise measurement of tumor formations, using CT/MR image reconstruction; color elastography is useful for tumor characterization and staging; endoscopic ultrasound using intravenous contrast agents can help study the amount of contrast agent targeted at the level of the tumor formations and contrast wash-in/wash-out time, based on the curves displayed on the device. The transvaginal approach often allows better visualization of the tumor than the transrectal approach. Performing the procedure with the rectal ampulla distended with contrast agent may be seen as an optimization of the examination methodology. All these aspects are additional methods for gray-scale endoscopic ultrasound, capable of increasing diagnostic accuracy. This paper aims at reviewing the progress of transrectal and transvaginal ultrasound, generically called endoscopic ultrasound, for rectal tumor diagnosis and staging, with emphasis on the current state of the method and its development trends.

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Endorectal elastography in the evaluation of rectal tumours

Abstract: Endorectal elastography can be performed as an integral part of the clinical evaluation of rectal tumours and has good patient compliance. The method is a promising modality for the discrimination between adenocarcinoma and adenoma of the rectum.

Cited by 52 publications

References 28 publications

Diagnosis of one small bowel tumor: the role of conventional ultrasound and elastography

Diagnosis of one small bowel tumor: the role of conventional ultrasound and elastography

Characterization and staging of rectal tumors: endoscopic ultrasound versus MRI / CT. Pictorial essay.

Endoscopic ultrasound for the characterization and staging of rectal cancer. Current state of the method. Technological advances and perspectives.

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