The Role of Endorectal Ultrasound and Magnetic Resonance Imaging in the Management of Early Rectal Lesions in a Tertiary Center

Patel, Rikesh; Sayers, Adele E.; Kumar, Prashanth; Khulusi, S.; Razack, Abdul; Hunter, Iain Andrew

doi:10.1016/j.clcc.2014.09.002

Cited by 20 publications

(18 citation statements)

References 27 publications

(37 reference statements)

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“…Conventional MRI has reportedly been used to stage CRC before surgery using multichannel phased‐array coils, parallel imaging methods, and more powerful gradient systems . Moreover, endoluminal MRI with endoluminal coils has been used for staging of rectal carcinomas .…”

Section: Discussionmentioning

confidence: 99%

“…CRC staging before surgery is presently based on the findings of computed tomography (CT) and endoscopic ultrasound (EUS), even though it is not possible to accurately assess the HG and extent of LNM by imaging alone because CT has poor soft‐tissue contrast and nonspecific size criteria, and EUS is limited by technical inadequacies to detect stenotic tumors, extraordinary operator reliance, interface echoes caused by artifacts, and an inadequate sonographic range . Although conventional magnetic resonance imaging (MRI) is an alternative to CT and EUS, this method is insufficient to assess the HG and extent of LNM in CRC …”

mentioning

confidence: 99%

“…[5][6][7] Although conventional magnetic resonance imaging (MRI) is an alternative to CT and EUS, 8,9 this method is insufficient to assess the HG and extent of LNM in CRC. [10][11][12][13][14][15][16][17][18][19] Overall, current diagnostic procedures for the diagnosis of CRC are relatively limited. To overcome these limitations, Yamada et al 20,21 recently reported that non-Gaussian q-space imaging (QSI) was suitable for ex vivo assessment of the HG and extent of LNM in esophageal and gastric carcinomas.…”

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confidence: 99%

See 2 more Smart Citations

Colorectal carcinoma: Ex vivo evaluation using q‐space imaging; Correlation with histopathologic findings

Yamada

Hikishima

Yoshino

et al. 2018

Magnetic Resonance Imaging

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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Colorectal carcinoma: Ex vivo evaluation using q‐space imaging; Correlation with histopathologic findings

Yamada

Hikishima

Yoshino

et al. 2018

Magnetic Resonance Imaging

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“…[68][69][70] Micrometastases are reported as high as 28% 65,71 and significantly contribute to false-negative lymph node findings on EUS. 65 EUS and MRI achieve comparable sensitivity and specificity for T-staging (70.8-90% vs 70-82% and both 100%) 72,73 and N-staging (67% vs 66% and 78% vs 76%). 74,75 Through-the-scope ultrasound mini-probe is an alternative EUS modality and allows inspection in the rectum and colon, with a pooled sensitivity and specificity of 91% and 98% for T1 cancer and 78% and 94% for T2 cancer, respectively.…”

Section: Summarizing Risk Factorsmentioning

confidence: 92%

“…EUS and MRI achieve comparable sensitivity and specificity for T‐staging (70.8–90% vs 70–82% and both 100%) and N‐staging (67% vs 66% and 78% vs 76%) …”

Section: Introductionmentioning

confidence: 98%

Management of colorectal T1 carcinoma treated by endoscopic resection from the Western perspective

Bartel

Brahmbhatt

Wallace

2016

Digestive Endoscopy

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Detection of early colorectal cancer is expected to rise in light of national colorectal cancer screening programs. This The present review article delineates current endoscopic risk assessments, differentiating invasive from non-invasive neoplasia, for high likelihood of lymph node metastasis in early colorectal cancer, also termed high-risk early colorectal cancer, and endoscopic and surgical resection methods from a Western hemisphere perspective.

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MRI cT1–2 rectal cancer staging accuracy: a population-based study

Detering

Oostendorp

Meyer

et al. 2020

British Journal of Surgery

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Background Adequate MRI‐based staging of early rectal cancers is essential for decision‐making in an era of organ‐conserving treatment approaches. The aim of this population‐based study was to determine the accuracy of routine daily MRI staging of early rectal cancer, whether or not combined with endorectal ultrasonography (ERUS). Methods Patients with cT1–2 rectal cancer who underwent local excision or total mesorectal excision (TME) without downsizing (chemo)radiotherapy between 1 January 2011 and 31 December 2018 were selected from the Dutch ColoRectal Audit. The accuracy of imaging was expressed as sensitivity, specificity, and positive predictive value (PPV) and negative predictive value. Results Of 7382 registered patients with cT1–2 rectal cancer, 5539 were included (5288 MRI alone, 251 MRI and ERUS; 1059 cT1 and 4480 cT2). Among patients with pT1 tumours, 54·7 per cent (792 of 1448) were overstaged by MRI alone, and 31·0 per cent (36 of 116) by MRI and ERUS. Understaging of pT2 disease occurred in 8·2 per cent (197 of 2388) and 27·9 per cent (31 of 111) respectively. MRI alone overstaged pN0 in 17·3 per cent (570 of 3303) and the PPV for assignment of cN0 category was 76·3 per cent (2733 of 3583). Of 834 patients with pT1 N0 disease, potentially suitable for local excision, tumours in 253 patients (30·3 per cent) were staged correctly as cT1 N0, whereas 484 (58·0 per cent) and 97 (11·6 per cent) were overstaged as cT2 N0 and cT1–2 N1 respectively. Conclusion This Dutch population‐based analysis of patients who underwent local excision or TME surgery for cT1–2 rectal cancer based on preoperative MRI staging revealed substantial overstaging, indicating the weaknesses of MRI and missed opportunities for organ preservation strategies.

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The Role of Endorectal Ultrasound and Magnetic Resonance Imaging in the Management of Early Rectal Lesions in a Tertiary Center

Cited by 20 publications

References 27 publications

Colorectal carcinoma: Ex vivo evaluation using q‐space imaging; Correlation with histopathologic findings

Colorectal carcinoma: Ex vivo evaluation using q‐space imaging; Correlation with histopathologic findings

Management of colorectal T1 carcinoma treated by endoscopic resection from the Western perspective

MRI cT1–2 rectal cancer staging accuracy: a population-based study

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