Transrectal ultrasonography and magnetic resonance imaging in the staging of rectal cancer. Effect of experience

Rafaelsen, Søren Rafael; Sørensen, Torben; Jakobsen, Anders; Bisgaard, Christer Z.; Lindebjerg, Jan

doi:10.1080/00365520701745842

Cited by 32 publications

(21 citation statements)

References 30 publications

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“…In one study, the sensitivity and specificity of an expert radiologist were 96% and 74% respectively, while the same figures for a general radiologist were 77% and 40% [20]. …”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging (MRI) in rectal cancer: a comprehensive review

2010

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Magnetic resonance imaging (MRI) has established itself as the primary method for local staging in patients with rectal cancer. This is due to several factors, most importantly because of the ability to assess the status of circumferential resection margin. There are several newer developments being introduced continuously, such as diffusion-weighted imaging and imaging with 3 T. Assessment of loco-regional lymph nodes has also been investigated extensively using different approaches, but more work needs to be done. Finally, evaluation of tumours during or after preoperative treatment is becoming an everyday reality. All these new aspects prompt a review of the most recent advances and opinions. In this review, a comprehensive overview of the current status of MRI in the loco-regional assessment and management of rectal cancer is presented. The findings on MRI and their accuracy are reviewed based on the most up-to-date evidence. Optimisation of MRI acquisition and relevant regional anatomy are also presented, based on published literature and our own experience.

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“…In one study, the sensitivity and specificity of an expert radiologist were 96% and 74% respectively, while the same figures for a general radiologist were 77% and 40% [20]. …”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging (MRI) in rectal cancer: a comprehensive review

2010

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“…The decision to implement these strategies however require accurate staging, which in Europe is more commonly provided by conventional MRI compared with in the United States, where endoscopic ultrasound (EUS) is more widely used (10). Although recent meta-analyses on the sensitivity and specificity of EUS for staging depth of invasion were reported to be between 80% and 96%, and 90% and 98%, and for assessing nodal metastases were 73% and 76%, respectively, inexperienced operators have been shown to provide less accurate staging (11)(12)(13). Overstaging, more common than understaging, has the consequence of subjecting patients to overtreatment.…”

Section: Introductionmentioning

confidence: 99%

Absence of MMP2 Expression Correlates with Poor Clinical Outcomes in Rectal Cancer, and Is Distinct from MMP1-Related Outcomes in Colon Cancer

Wong

Chan

Schaeffer

et al. 2011

Clinical Cancer Research

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Purpose: Treatments for colorectal cancer (CRC) are primarily disease stage based. However, heterogeneity in outcome within even a single stage highlights its limitations in predicting disease behavior. Recently, the role of gene expression as predictive and prognostic markers has been explored. Our objectives were to identify consistently differentially expressed genes through meta-analysis of highthroughput gene-expression studies, and evaluate their predictive and prognostic significance in colon (CC) and rectal (RC) cancers.Experimental Design: Publications applying high-throughput gene-expression technologies to specific CRC stages were identified. A vote counting strategy was used to identify the most significant differentially expressed genes. Their predictive and prognostic values were independently assessed in a tissue microarray of 191 cases of stage II-IV CC/RC from two tertiary care centers. Their biological effects were also examined in vitro.Results: MMP1 and MMP2 were identified as consistently underexpressed in liver metastasis compared with primary CRC. Shorter time to distant metastasis and overall survival occurred in stage III CC lacking MMP1 expression, and in stage III RC lacking MMP2. MMP1 levels in stage II and III CC were associated with increased likelihood of distant metastasis, whereas the risk of local recurrence in stage III RC could be stratified by MMP2. Promotion of cell invasion of CRC cell lines exposed to MMP1/2 inhibitors were confirmed in vitro.Conclusions: MMP1 and MMP2 may be useful biomarkers that can help stratify patients at higher risk of developing recurrence in colorectal cancer, and guide individualized treatment decisions to achieve better outcomes.

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“…[7][8][9]11,15,16 Overstaging can be explained by several reasons. First, Katsura et al reported that peritumoral inflammation can make echogenic layers become hypoechoic, resulting in overstaging of rectal lesions.…”

Section: Discussionmentioning

confidence: 99%