Magnetic resonance imaging of rectal carcinoma: A prospective study

Mcnicholas, M. M. J.; Joyce, William; Dolan, James G.; Gibney, R G; MacErlaine, Donal P.; Hyland, John

doi:10.1002/bjs.1800810640

Cited by 69 publications

(27 citation statements)

References 29 publications

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“…Lymph nodes of 5 mm diameter or greater were reported as nodal metastases while those lesser than 5 mm diameter were considered to be uninvolved [13] .…”

Section: Mrimentioning

confidence: 99%

Endorectal ultrasonography versus phased-array magnetic resonance imaging for preoperative staging of rectal cancer

Halefoğlu¹,

Yıldırım²,

Avlanmis³

et al. 2008

WJG

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AIM:To compare the diagnostic accuracy of pelvic phased-array magnetic resonance imaging (MRI) and endorectal ultrasonography (ERUS) in the preoperative staging of rectal carcinoma. METHODS: Thirty-four patients (15 males, 19 females) with ages ranging between 29 and 75 who have biopsy proven rectal tumor underwent both MRI and ERUS examinations before surgery. All patients were evaluated to determine the diagnostic accuracy of depth of transmural tumor invasion and lymph node metastases. Imaging results were correlated with histopathological findings regarded as the gold standard and both modalities were compared in terms of predicting preoperative local staging of rectal carcinoma. RESULTS: The pathological T stage of the tumors was: pT1 in 1 patient, pT2 in 9 patients, pT3 in 21 patients and pT4 in 3 patients. The pathological N stage of the tumors was: pN0 in 19 patients, pN1 in 9 patients and pN2 in 6 patients. The accuracy of T staging for MRI was 89.70% (27 out of 34). The sensitivity was 79.41% and the specificity was 93.14%. The accuracy of T staging for ERUS was 85.29% (24 out of 34). The sensitivity was 70.59% and the specificity was 90.20%. Detection of lymph node metastases using phased-array MRI gave an accuracy of 74.50% (21 out of 34). The sensitivity and specificity was found to be 61.76% and 80.88%, respectively. By using ERUS in the detection of lymph node metastases, an accuracy of 76.47% (18 out of 34) was obtained. The sensitivity and specificity were found to be 52.94% and 84.31%, respectively. CONCLUSION: ERUS and phased-array MRI are complementary methods in the accurate preoperative staging of rectal cancer. In conclusion, we can state that phased-array MRI was observed to be slightly superior in determining the depth of transmural invasion (T stage) and has same value in detecting lymph node metastases (N stage) as compared to ERUS.

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“…Lymph nodes of 5 mm diameter or greater were reported as nodal metastases while those lesser than 5 mm diameter were considered to be uninvolved [13] .…”

Section: Mrimentioning

confidence: 99%

Endorectal ultrasonography versus phased-array magnetic resonance imaging for preoperative staging of rectal cancer

Halefoğlu¹,

Yıldırım²,

Avlanmis³

et al. 2008

WJG

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“…However, this limitation is unavoidable because preoperative chemoradiotherapy is now the standard of care for presumed stage II/III cancers (8,9). If we had excluded the patients with stage II/III disease, we would have underestimated the accuracy, since MRI has been shown to be highly accurate in assessing advanced disease (11,46).…”

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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“…Thaler [22] found TRUS mo re accurate than MRI (80% versus 60%). Using MRI, McNicolas [27] reported a 95% accuracy, where as Drew [25] reported only a 58% positive predictive value. While TRUS and MRI are both reasonably sensitive at staging the depth of tumour, MRI is better at assessing tumour extension into adjacent organs.…”

Section: Trans-rectal Ultrasound and Magnetic Resonance Imagingmentioning

confidence: 99%

The impact of new technology on surgery for colorectal cancer

Makin¹,

Breen²,

Monson³

2001

WJG

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Advances in technology continue at a rapid pace and affect all aspects of life, including surgery. We have reviewed some of these advances and the impact they are having on the investigation and management of c o l o r e c t a l c a n c e r . M o d e r n e n d o s c o p e s , w i t h magnifying, variable stiffness and localisation capabilities are making the primary investigation of colonic cancer easier and more acceptable for patients. Imaging investigations looking at primary, metastatic and recurrent disease are shifting to digital data sets, which can be stored, reviewed remotely, potentially fused with other modalities and reconstructed as 3 dimensional (3D) images for the purposes of advanced diagnostic interpretation and computer assisted surgery. They include virtual colonoscopy, trans-rectal ultrasound, magnetic resonance imaging, positron emission tomography and radioimmunoscintigraphy. Once a colorectal carcinoma is diagnosed, the treatment options available are expanding. Colonic stents are being used to relieve large bowel obstruction, either as a palliative measure or to improve the patient's overall condition before definitive surgery. Transanal endoscopic microsurgery and minimally invasive techniques are being used with similar outcomes and a lower mortality, morbidity and hospital stay than open trans-abdominal surgery. Transanal endoscopic microsurgery allows precise excision of both benign and early malignant lesions in the mid and upper rectum. Survival of patients with i n o p e r a b l e h e p a t i c m e t a s t a s e s f o l l o w i n g radiofrequency ablation is encouraging. Robotics and telemedicine are taking surgery well into the 21 st century. Artificial neural networks are being developed to enable us to predict the outcome for individual patients. New technology has a major impact on the way we practice surgery for colorectal cancer.Subject headings colorectal neoplasms; technology; surgery; radiology

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Magnetic resonance imaging of rectal carcinoma: A prospective study

Cited by 69 publications

References 29 publications

Endorectal ultrasonography versus phased-array magnetic resonance imaging for preoperative staging of rectal cancer

Endorectal ultrasonography versus phased-array magnetic resonance imaging for preoperative staging of rectal cancer

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

The impact of new technology on surgery for colorectal cancer

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