Prospective comparative study of magnetic resonance imaging versus transrectal ultrasound for preoperative staging and follow-up of rectal cancer

Abstract

The efficiency of magnetic resonance imaging (MRI) and that of transrectal ultrasound (TRUS) were compared in preoperative staging of 15 patients with rectal cancer and in postoperative follow-up of 12 patients. Thirteen of the 15 patients evaluated for preoperative staging were operated on. Preoperative staging and pathologic finding were identical in 11 patients (84.6 percent) examined by TRUS and in 10 patients (76.9 percent) examined by MRI. Recurrent cancer was detected in 3 of 12 patients in the follow-up group. MRI was able to diagnose correctly 10 of 12 patients (83.2 percent), one patient was misdiagnosed, and in one patient the MRI could not distinguish between fibrous tissue and recurrent cancer. TRUS diagnosed correctly only 5 of 12 patients (41.6 percent). One was falsely diagnosed, and, in 6 patients (50 percent), this examination could not differentiate between fibrous tissue and recurrent tumor. According to our results, both MRI and TRUS have a place in the preoperative staging of patients with rectal cancer. The main differences between the two methods were in the differential diagnoses of fibrous tissue and recurrent cancer. MRI being more specific in detection of recurrence.

Role of Transrectal Ultrasound in Preoperative Local Staging of Carcinoma Rectum and It’s Histopathological Correlation

“…In addition, CT scanning is not accurate in assessing the depth of wall penetration in the rectum and appears to lack an ability to detect pelvic lymph nodes. TRUS is a new diagnostic modality that has become useful in aiding the surgeon in selecting the appropriate therapy for rectal cancer because of its high accuracy in determining the depth of invasion of the rectal cancer and the presence or absence of metastatic lymph nodes preoperatively [1,3]. When the accuracy of ultrasonographically is determined, the depth of invasion is compared with the histologic results; accuracy rates in the 90 % range have been documented by many authors [4,5].…”

“…When the accuracy of ultrasonographically is determined, the depth of invasion is compared with the histologic results; accuracy rates in the 90 % range have been documented by many authors [4,5]. Some studies have shown the superiority of transrectal ultrasonography compared to CT scanning, but others have shown little difference [3,7]. Even though overall accuracy rates are strongly dependent on the investigator's experience.…”

“…Inability to assess for distance metastases 3. Inherent difficulties in interpreting subtle differences between different stages of rectal wall penetration and lymph node metastases 3 Invasion through muscularis propria into perirectal fat. Outer (hyperechoic) white line (junction of muscularis propria with perirectal fat) is disrupted.…”

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

“…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 .…”

The impact of new technology on surgery for colorectal cancer

“…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).…”