MRI of rectal carcinoma: Preoperative staging and planning of sphincter-sparing surgery

Ghieda, Usama Elsaied; Hassanen, Omar; Eltomey, Mohamed Adel

doi:10.1016/j.ejrnm.2013.11.004

Cited by 6 publications

(3 citation statements)

References 22 publications

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“…The overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI-based T-staging were 92.8, 88.8%, 96.5%, 96%, and 90.3%, respectively. That was in agreement with Ghieda et al [ 28 ] and Iannicelli et al [ 5 ] who stated that differentiation between intramural tumors and T3 borderline lesions still remains a diagnostic problem, based on the fact that it is often not possible to distinguish a true mesorectal tumor invasion from desmoplastic reaction or inflammatory peritumoral tissue that may or may not contain tumor cells.…”

Section: Discussionsupporting

confidence: 90%

The Value of High-Resolution MRI Technique in Patients with Rectal Carcinoma: Pre-Operative Assessment of Mesorectal Fascia Involvement, Circumferential Resection Margin and Local Staging

et al. 2015

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SummaryBackgroundThe purpose of the study was to identify the accuracy of high-resolution MRI in the pre-operative assessment of mesorectal fascia involvement, circumfrential resection margin (CRM) and local staging in patients with rectal carcinoma.Material/MethodsThe study included 56 patients: 32 male and 24 female. All patients underwent high-resolution MRI and had confirmed histopathological diagnosis of rectal cancer located within 15 cm from the anal verge, followed by surgery. MRI findings were compared with pathological and surgical results.ResultsThe overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI-based T-staging were 92.8, 88.8%, 96.5%, 96%, and 90.3%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based assessment of CRM were 94.6%, 84.6%, 97.6%, 91.4, and 94.6%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based N-staging were 82.1%, 75%, 67.3%, 60%, and 86.1%, respectively.ConclusionsPreoperative high-resolution rectal MRI is accurate in predicting tumor stage and CRM involvement. MRI is a precise diagnostic tool to select patients who may benefit from neo-adjuvant therapy and to avoid overtreatment in those patients who can proceed directly to surgery.

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Section: Discussionsupporting

confidence: 90%

The Value of High-Resolution MRI Technique in Patients with Rectal Carcinoma: Pre-Operative Assessment of Mesorectal Fascia Involvement, Circumferential Resection Margin and Local Staging

et al. 2015

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“…7 These days, accurate preoperative assessment is mandatory as treatment includes an aggressive multi-disciplinary approach that includes associated individual risk factors. 8 Various imaging studies are currently being used for screening and staging colorectal cancer. Due to multiplaner reconstruction, cross-sectional studies such as CT scans, colonographic studies, magnetic resonance imaging & positron emission tomography (PET) provide more accurate anatomic details about primary tumours and the extent of disease involvement.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Multidetector Computed Tomography in Detecting Mesorectal Fascia Involvement in Colorectal Carcinoma

Panezai

Anwar²,

Khattak³

et al. 2022

PAFMJ

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Objectives: To determine the diagnostic accuracy of multi detector computed tomography (MDCT) in detecting mesorectal fascia involvement in colorectal carcinoma, taking histopathology as a gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Department of Radiology, Combined Military Hospital Quetta from Jun to Dec 2019. Methodology: A total of 117 suspected patients of colorectal carcinoma, aged 40-80 years of either gender were included. All the patients underwent MDCT and then were looked for mesorectal fascia involvement. After surgical intervention, the his to pathological result of respected specimens was correlated with MDCT findings. Results: MDCT showed mesorectal fascia involvement in 66 (56.41%) patients. Histopathology confirmed mesorectal fascia involvement in 62 (52.99%) cases, whereas 55 (47.01%) patients revealed no mesorectal fascia involvement. In MDCT positive patients, 56 patients were true positive, while ten patients were false positive. Among 51 MDCT negative patients, 6 were false-negative while 45 were true negative. Overall results of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of MDCT in detecting mesorectal fascia involvement, taking histopathology as the gold standard was, 90.32%, 81.82%, 84.85%, 88.24% and 86.32% respectively. Conclusion: This study concluded that MDCT is a recommended modality due to its high sensitivity. It is an accurate modality for pre-operative detecting mesorectal fascia involvement in colorectal carcinoma patients.

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“…Because of the risk of local recurrence and the associated poor prognosis, appropriate surgical resection is required. Patients' quality of life is another issue, and for this reason, sphincter-sparing surgery has become a desirable option; it results in fewer complications than those associated with abdominoperineal resection (2).…”

Section: Introductionmentioning

confidence: 99%

Defining the distal margin of rectal cancer for surgical planning

Sato

Kato

Tanaka

2017

J. Gastrointest. Oncol.

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Accurate measurement of the distal rectal tumor margin is essential in selecting the appropriate surgical procedure. However, there is no standard measurement method. The National Cancer Institute consensus group recommends use of the anal verge (AV) as a landmark, and the European Society of Gastrointestinal and Abdominal Radiology recommends use of the anorectal ring (ARR). In addition, whether measurements should be made on double contrast barium enema (BE) radiographs or magnetic resonance (MR) images remains controversial. We measured the distal tumor margin on both BE and MR images obtained preoperatively from 52 patients who underwent sphincter-saving resection for rectal cancer.The distances from the distal end of the tumor to the AV and the ARR were measured on both types of images, and the variability was investigated by Bland-Altman analysis. The mean distance from the tumor to the AV was 8.9 cm on the BE radiographs and 7.7 cm on the MR images (P=0.013). The mean distances to the ARR were 6.8 and 5.6 cm, respectively (P=0.070). Significant proportional bias was shown as the measured distances increased, the difference between the BE-and magnetic resonance imaging (MRI)-based measurements increased. Use of one or the other landmark did not affect selection of the appropriate surgical procedure. We conclude that an approximate 1-cm underestimation should be taken into account when MRI-based measurement of the distal rectal tumor margin is used to choose between sphincter-saving resection and abdominoperineal resection.

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MRI of rectal carcinoma: Preoperative staging and planning of sphincter-sparing surgery

Cited by 6 publications

References 22 publications

The Value of High-Resolution MRI Technique in Patients with Rectal Carcinoma: Pre-Operative Assessment of Mesorectal Fascia Involvement, Circumferential Resection Margin and Local Staging

The Value of High-Resolution MRI Technique in Patients with Rectal Carcinoma: Pre-Operative Assessment of Mesorectal Fascia Involvement, Circumferential Resection Margin and Local Staging

Diagnostic Accuracy of Multidetector Computed Tomography in Detecting Mesorectal Fascia Involvement in Colorectal Carcinoma

Defining the distal margin of rectal cancer for surgical planning

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