Preoperative staging of rectal cancer by endoluminal ultrasound vs. magnetic resonance imaging

Thaler, W.; Watzka, Stefan B.; Martin, Federico; Guardia, Giuseppe La; Psenner, Konrad; Bonatti, Gianpietro; Fichtel, Gertrud; Egarter-Vigl, Eduard; Marzoli, G. P.

doi:10.1007/bf02257780

Cited by 168 publications

(66 citation statements)

References 18 publications

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“…Its overall accuracy before radiation ranges from 73% to 94% in T staging, and from 70% to 80% in N staging. Comparative studies found EUS very accurate in staging rectal cancer from 80% to 95%, compared to 65% to 75% for CT and 75% to 85% for MRI [6][7][8][9] . CT and MRI have proved disappointing for detecting small neoplastic lesions.…”

Section: Mezzi G Et Al Eus and Mri In Rectal Cancermentioning

confidence: 95%

“…Rectal EUS helps select a group with advanced locoregional disease (stage T3 or T4) in whom this preoperative treatment offers most benefit [3][4][5] . The accuracy of EUS in staging rectal cancer ranges from 80% to 95% compared to 65%-75% for computed tomography (CT) and 75%-85% for magnetic resonance imaging (MRI) [6][7][8][9] . There is still debate about the role of cross-sectional imaging to restage rectal cancer after RT-CT, and data are scanty on accuracy, sensitivity, and specificity rates, suggesting that these modalities are not efficient enough for restaging.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic ultrasound and magnetic resonance imaging forre-staging rectal cancer after radiotherapy

Mezzi¹,

Arcidiacono²,

Carrara³

et al. 2009

WJG

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AIM:To compare the sensitivity and specificity of two imaging techniques, endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI), in patients with rectal cancer after neoadjuvant chemoradiation therapy. And we compared EUS and MRI data with histological findings from surgical specimens. METHODS:Thirty-nine consecutive patients (51.3% Male; mean age: 68.2 ± 8.9 years) with histologically confirmed distal rectal cancer were examined for staging. All patients underwent EUS and MRI imaging before and after neoadjuvant chemoradiation therapy. RESULTS:After neoadjuvant chemoradiation, EUS and MRI correctly classified 46% (18/39) and 44% (17/39) of patients, respectively, in line with their histological T stage (P > 0.05). These proportions were higher for both techniques when nodal involvement was considered: 69% (27/39) and 62% (24/39). When patients were sorted into T and N subgroups, the diagnostic accuracy of EUS was better than MRI for patients with T0-T2 (44% vs 33%, P > 0.05) and N0 disease (87% vs 52%, P = 0.013). However, MRI was more accurate than EUS in T and N staging for patients with more advanced disease after radiotherapy, though these differences did not reach statistical significance.CONCLUSION: EUS and MRI are accurate imaging techniques for staging rectal cancer. However, after neoadjuvant RT-CT, the role of both methods in the assessment of residual rectal tumors remains uncertain.

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Section: Mezzi G Et Al Eus and Mri In Rectal Cancermentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound and magnetic resonance imaging forre-staging rectal cancer after radiotherapy

Mezzi¹,

Arcidiacono²,

Carrara³

et al. 2009

WJG

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“…La resonancia magnética de pelvis presenta resultados similares a la ER en la etapificación del cáncer de recto 20,21 , en particular con el uso de la bobina endorectal 22,23 . Sin embargo en lesiones tumorales tempranas, la ER mantiene una ventaja respecto a la resonancia 24 .…”

Section: Discussionunclassified

Endosonografía rectal en la evaluación de focos de cáncer en adenomas rectales

D¹,

et al. 2008

Rev Chil Cir

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RESUMENIntroducción: Entre un 30-40% de los Adenomas Vellosos (AV) rectales pueden presentar cáncer, lo que clínicamente puede no ser evidente, e incluso la biopsia endoscópica puede resultar negativa. Comunicaciones recientes sugieren que la Endosonografía Rectal (ER) sería un método apropiado para detectar focos de carcinoma invasor en AV. Objetivo: Evaluar la utilidad de la ER en la detección de focos de carcinoma invasor en AV y su eventual compromiso ganglionar. Material y método: Se analizaron en forma consecutiva 1400 ER, realizadas entre Febrero del 2000 y Julio del 2006 en el Hospital U.C. Se seleccionaron aquellas ER informadas como AV rectal. El informe de ER en cuanto a la extensión del tumor en la pared y el compromiso ganglionar (uT, uN) fue comparado con el informe de anatomía patológica de la pieza quirúrgica (pT, pN). Resultados: En 28 de los 35 pacientes con ER informadas como AV rectal se pudo contar con el estudio anatomopatológico y son quienes constituyen esta serie. En 17 pacientes se encontró cáncer invasor en el estudio anatomopatológico (60,7%). La concordancia entre ER y el estudio patológico para identificar focos de cáncer en AV fue 82%. El VPP fue 100%, el VPN 69%, la sensibilidad 71% y la especificidad 100%. La concordancia para diferenciar lesiones T0-T1 de lesiones más profundas fue 75%, y para establecer invasión ganglionar fue 84%. Conclusión: La ER permite una adecuada detección de focos de cáncer en AV junto a una apropiada etapificación.PALABRAS CLAVE: Adenoma rectal, endosonografía rectal, adenocarcinoma rectal, etapificación preoperatoria. ABSTRACTBackground: Thirty to forty percent of villous adenomas can be an occult carcinoma. Even biopsy can miss the diagnosis. Rectal endosonography can be useful to detect these malignant tumors. Aim: To assess the usefulness of rectal endosonography to detect invasive carcinoma and eventual lymph node involvement in villous adenomas. Material and methods: Retrospective review of 1400 rectal endosonographies performed between years 2000 and 2006. Those cases in which a rectal villous adenoma was informed, that were subjected to surgical excision and that had a pathology report were included in the study. Results:

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“…This in part depends on the MRI technique, whether a surface (phasedarray) or an endo-rectal coil is used and is operator dependent. Satoh [21] found TRUS more accurate than MRI, while Thaler [22] and Waizer [23] found no difference between the two. In two recent prospective comparative studies there was no significant difference between TRUS and endo-rectal MRI in both T and N [24] ( Tables 2 and 3).…”

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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Preoperative staging of rectal cancer by endoluminal ultrasound vs. magnetic resonance imaging

Abstract: We suggest that ELUS and MRI must be evaluated within the framework of established parameters when treatment modalities such as preoperative radiation therapy and local or radical surgical approach must be decided.

Cited by 168 publications

References 18 publications

Endoscopic ultrasound and magnetic resonance imaging forre-staging rectal cancer after radiotherapy

Endoscopic ultrasound and magnetic resonance imaging forre-staging rectal cancer after radiotherapy

Endosonografía rectal en la evaluación de focos de cáncer en adenomas rectales

The impact of new technology on surgery for colorectal cancer

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