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Pre-operative staging of rectal cancer using multi-detector row computed tomography with multiplanar reformations:
R A Dar1, N A Chowdri, F Q Parray
1Department of General and Minimal Invasive Surgery, Sher-i-Kashmir Institute of Medical Sciences, Soura, India.
Background:
Technical advancement in imaging has helped to stage and plan treatment modality for carcinoma rectum with still some objectives controversial.
Aims:
The aim of our study was to evaluate the accuracy of multidetector row computed tomography (MDCT) with multiplanar reformations in the pre-operative staging of rectal carcinoma and correlation with intraoperative and histopathologic staging of retrieved specimen with respect to the depth of tumor invasion (T-staging), lymph node metastasis (N-staging) and mesorectal fascia (MRF) involvement.
Materials And Methods:
The study was a prospective one and consisted of 52 patients with biopsy proved rectal carcinoma. MDCT studies were performed on a 64-slice computed tomography system. Images were reconstructed in axial, coronal and sagittal planes. MDCT findings were compared with intraoperative and pathologic (reference standard) findings. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were assessed.
Results:
The diagnostic accuracy of MDCT for T1/T2, T3 and T4 lesions was 77%, 86.5% and 100%, respectively. For perirectal lymph node metastasis (N+), the diagnostic accuracy of MDCT was 84.1%. The diagnostic accuracy of MDCT for MRF involvement was 91%.
Conclusion:
MDCT is a reliable radiological tool for local staging of rectal cancer with excellent accuracy rates for T and N-staging of rectal cancer.
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