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Accuracy of high-resolution magnetic resonance imaging in preoperative staging of rectal cancer.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2009 Oct; Vol. 16 (10), pp. 2787-94. Date of Electronic Publication: 2009 Jul 18. - Publication Year :
- 2009
-
Abstract
- Background: To achieve better prognosis and quality of life for patients with rectal cancer, extent of surgery and neoadjuvant chemoradiotherapy should accurately reflect disease extent. The aim of this study was to evaluate accuracy of high-resolution magnetic resonance imaging (HRMRI) for preoperative staging of rectal cancer.<br />Methods: Between 2001 and 2003, 104 patients with primary rectal cancer were examined with HRMRI and underwent radical surgery. Transmural invasion depth and lymph node metastasis were assessed prospectively and classified according to the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) system by both HRMRI and histopathology, and results were compared. Criteria for mesorectal and lateral pelvic lymph node involvement were short-axis diameters of > or =5 mm and > or =4 mm, respectively.<br />Results: There were 15 pT1, 25 pT2, 50 pT3, and 14 pT4 tumors. Overall accuracy rate for transmural invasion depth was 84%. The mesorectal fascia could be visualized in 98% of patients. Twenty-three patients had mesorectal fascia involvement and the overall accuracy rate was 96% (sensitivity, 96%; specificity, 96%). Fifty-three patients had mesorectal lymph node metastasis and the overall accuracy rate was 74% (sensitivity, 83%; specificity, 64%). Lateral pelvic lymph node metastasis was observed in 15 patients and the overall accuracy rate was 87% (sensitivity, 87%; specificity, 87%).<br />Conclusions: HRMRI was moderately accurate for prediction of mesorectal lymph node metastasis and highly accurate regarding transmural invasion depth, and mesorectal fascia and lateral pelvic node involvement. Therefore, HRMRI appears useful for preoperative decision-making in rectal cancer treatment.
- Subjects :
- Adenocarcinoma, Mucinous surgery
Adult
Aged
Aged, 80 and over
Female
Humans
Lymph Nodes pathology
Lymph Nodes surgery
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Pelvic Neoplasms surgery
Preoperative Care
Prognosis
Prospective Studies
Rectal Neoplasms surgery
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed
Adenocarcinoma, Mucinous secondary
Magnetic Resonance Imaging
Pelvic Neoplasms secondary
Rectal Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 16
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 19618244
- Full Text :
- https://doi.org/10.1245/s10434-009-0613-3