Author of 1 Presentation
SS 2.9 - Diagnostic performance of dedicated rectal CT for staging rectal cancer: comparison with high-resolution rectal MRI and histopathology
Abstract
Purpose
To evaluate the diagnostic performance of dedicated rectal CT compared with high-resolution rectal MRI and histopathology in assessing rectal cancer.
Material and methods
Sixty-seven rectal cancer patients, who underwent dedicated rectal CT with rectal distension using 80-100ml of sonographic gel and high-resolution MRI within a month, were enrolled. For rectal CT, axial, coronal, and sagittal images were acquired with 3-mm reconstruction interval. For CT and MRI, the following items were analyzed by an experienced gastrointestinal radiologist: distance from anal verge and anorectal junction, shortest distance to mesorectal fascia, extramural depth (EMD), extramesorectal lymph node (LN) involvement, extramural venous invasion (EMVI), and T and N stages. CT and MRI findings were compared. Of 67 patients, 20 underwent radical surgery without concurrent chemoradiation therapy for whom CT findings were also compared with histopathology. Interclass correlation (ICC) and kappa statistics were used for statistical analysis.
Results
For all patients, distance from anal verge and anorectal junction showed strong correlation between CT and MRI (correlation coefficient, 0.972 and 0.955) (P<0.001). For EMD (cut-off: 5mm), threatened circumferential resection margin (cut-off: <2mm), LN metastasis, extramesorectal LN, and EMVI, kappa values between CT and MRI were 0.944, 0.931, 1.000, 0.892, and 0.884, respectively (P<0.001). For T stage, a weighted-kappa value was 0.954 (P<0.001). For 20 patients who received surgery, CT showed good agreement for T staging with histopathologic staging (kappa value, 0.865) (P<0.001). For involvement of CRM, EMVI, and LN metastasis, rectal CT showed acceptable concordance rates with histopathology in 75% (15/20), 95% (19/20), and 60% (12/20), respectively.
Conclusion
Dedicated rectal CT shows acceptable diagnostic performance comparable with MRI and histopathology for evaluating rectal cancers.
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Author of 1 Presentation
SS 2.9 - Diagnostic performance of dedicated rectal CT for staging rectal cancer: comparison with high-resolution rectal MRI and histopathology (ID 690)
Abstract
Purpose
To evaluate the diagnostic performance of dedicated rectal CT compared with high-resolution rectal MRI and histopathology in assessing rectal cancer.
Material and methods
Sixty-seven rectal cancer patients, who underwent dedicated rectal CT with rectal distension using 80-100ml of sonographic gel and high-resolution MRI within a month, were enrolled. For rectal CT, axial, coronal, and sagittal images were acquired with 3-mm reconstruction interval. For CT and MRI, the following items were analyzed by an experienced gastrointestinal radiologist: distance from anal verge and anorectal junction, shortest distance to mesorectal fascia, extramural depth (EMD), extramesorectal lymph node (LN) involvement, extramural venous invasion (EMVI), and T and N stages. CT and MRI findings were compared. Of 67 patients, 20 underwent radical surgery without concurrent chemoradiation therapy for whom CT findings were also compared with histopathology. Interclass correlation (ICC) and kappa statistics were used for statistical analysis.
Results
For all patients, distance from anal verge and anorectal junction showed strong correlation between CT and MRI (correlation coefficient, 0.972 and 0.955) (P<0.001). For EMD (cut-off: 5mm), threatened circumferential resection margin (cut-off: <2mm), LN metastasis, extramesorectal LN, and EMVI, kappa values between CT and MRI were 0.944, 0.931, 1.000, 0.892, and 0.884, respectively (P<0.001). For T stage, a weighted-kappa value was 0.954 (P<0.001). For 20 patients who received surgery, CT showed good agreement for T staging with histopathologic staging (kappa value, 0.865) (P<0.001). For involvement of CRM, EMVI, and LN metastasis, rectal CT showed acceptable concordance rates with histopathology in 75% (15/20), 95% (19/20), and 60% (12/20), respectively.
Conclusion
Dedicated rectal CT shows acceptable diagnostic performance comparable with MRI and histopathology for evaluating rectal cancers.