Management of rectal carcinoma: impact of computed tomography

Waes, P. F. G. M. van; Koehler, P. Ruben; Feldberg, M. A. M.

doi:10.2214/ajr.140.6.1137

Cited by 70 publications

(28 citation statements)

References 0 publications

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“…Shuiciro et al [25] and Mainenti et al [41] report that PET/CT has high detectability rate increasing 90% for T colorectal cancer staging (95% and 94.3%, respectively). In addition, 18 F-FDG PET/CT shows higher sensitivity for T staging if compared to MDTC (95% versus 78.8%) [25]. Our results detected no significant difference in T staging after comparison between 18 F-FDG PET/CT results and histopathological results.…”

Section: Discussioncontrasting

confidence: 48%

“…Our results showed that treatment modality would have been changed in 80% of patients if each of our patients had undergone 18 F-FDG PET/CT imaging preoperatively; with upstaging in 2 (4.4%) patients (from T2 stage into T3 stage) and downstaging in 43 (95.6%) patients. In relation to the change in T staging, patients with advanced tumor stage would have been treated by neoadjuvant chemoradiation therapy instead of curative surgery.…”

Section: Change In Treatment Managementmentioning

confidence: 79%

“…The CT imaging has low accuracy in T staging of 52%-74%, but it increases in more locally advanced tumors reaching the accuracy of 79%-94% [18][19][20][21]. The main disadvantage of CT is low spatial and contrast resolution, however its role is mostly in the detection of distant metastases.…”

Section: Discussionmentioning

confidence: 99%

“…Forty-five patients with colorectal cancer who underwent 18 F-FDG PET/CT imaging during the period from 2011 to 2014 were analyzed in this study. Inclusion criteria for this study were: patients under 70 years of age with histologically proven rectal malignancy after endoscopy in whom surgical treatment was indicated; no coexisting second primary malignancy; ECOG (Eastern Cooperative Group) patient performance status was 0, 1 or 2; and no presence of comorbidities (e.g.…”

Section: Patientsmentioning

confidence: 99%

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IS There A Role of 18F-FDG PET/CT for Initial Staging of Rectal Cancer ?

Mihaïlovic¹,

Ivanov²,

Bunovic³

et al. 2017

JPP

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respectively. The overall sensitivity, specificity and accuracy of 18 F-FDG PET/CT in detection of metastatic lymph node was 85.8%, 89.8%, and 89%, respectively. PET/CT shows low sensitivity (77.3%) and specificity (25%) in analyzing mesorectal fascia involvement. The overall sensitivity of 18 F-FDG PET/CT in M staging was 100%. Conclusions: 18 F-FDG PET/CT is highly sensitive for initial T staging of rectal cancer especially in advanced disease. This imaging modality is highly accurate in detection of metastatic lymph nodes and liver metastases, but it has no role in defining of mesorectal fascia involvement. Therefore, 18 F-FDG PET/CT should be incorporated routinely in preoperative staging together with conventional imaging.

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Section: Discussioncontrasting

confidence: 48%

Section: Change In Treatment Managementmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

See 2 more Smart Citations

IS There A Role of 18F-FDG PET/CT for Initial Staging of Rectal Cancer ?

Mihaïlovic¹,

Ivanov²,

Bunovic³

et al. 2017

JPP

View full text Add to dashboard Cite

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“…Preoperative staging using CT scans in rectal cancer patients was first reported in the early 1980s. Early reports with conventional CT mainly focused on locally advanced rectal cancer and the accuracies for the T3 stage were 79 94% (12)(13)(14). Most early studies were performed using nonhelical CT units that were limited by a lack of the high resolution, thin collimation images achievable by the current MDCT instruments.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Assessment of Mesorectal Fascial Involvement in Patients with Rectal Cancer: The Diagnostic Value of MDCT for Measuring the Mesorectal Fascial Thickness

Seo

Yoon

Lee

et al. 2007

J Korean Radiol Soc

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Purpose: To assess the diagnostic value of the use of multi-detector row computed tomography (MDCT) in evaluating mesorectal fascial (MRF) involvement in patients with T3 stage rectal cancer. Materials and Methods: From September 2005 to June 2006, we enrolled 21 patients with T3 stage rectal cancer. In addition, 21 healthy patients were enrolled in a control group. Two radiologists measured the mean MRF thickness independently. We considered positive MRF involvement when the MRF thickness exceeded 4 mm, and then we measured the MRF thickness of patients with T3 rectal cancer. We analyzed interobserver agreement for the measured MRF thickness of the control group and assessed the diagnostic value of 4 mm, 5 mm and 6 mm as references in predicting MRF involvement. Results:The mean MRF thickness of the control group was 3.24 0.50 mm (radiologist 1) and 3.04 0.51 mm (radiologist 2). Using 4 mm, 5 mm and 6 mm as a reference thickness in predicting MRF involvement, sensitivity was 100%, 100% and 28.57%, specificity was 71.43%, 85.71% and 92.86%, the false negative rate (FNR) was 0%, 0% and 71.43%, the false positive rate (FPR) was 28.57%, 14.29% and 7.14%, the negative predictive value (NPV) was 100%, 100% and 72.2%, the positive predictive value (PPV) was 63.64%, 77.78% and 66.7%, and the accuracy was 80.95%, 90.48% and 71.43%. Conclusion: Preoperative assessment of the MRF thickness on MDCT is beneficial in predicting MRF involvement in patients with advanced rectal cancer and a value of 5 mm as a reference MRF thickness was established.

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