Purpose

To evaluate multidetector computed tomography (MDCT) performance in the preoperative local staging in colon cancer, focusing on the differentiation between T3ab from T3cd/T4 disease.

Material and methods

In this retrospective study, preoperative MDCTs of 33 patients with colon adenocarcinoma were evaluated regarding T (T3ab, T3cd and T4) and N staging (N0/N+) by two observers blinded to each other’s readings and to the pathological reports. Results were compared with histopathology (gold standard) and sensitivity, specificity and accuracy were calculated. Interobserver agreement was compared using κ statistics.

Results

MDCT had high sensitivity in the differentiation between T3ab and T3cd/T4 tumors (81,5-85,2%) but moderate specificity (50%) and moderate interobserver agreement was observed (ĸ=0,57).

In the detection of lymph node metastases, MDCT showed a moderate to high sensitivity (61,5-84,6%), moderate specificity (57,1%) and an accuracy of 60,6-78,8%. Interobserver agreement was moderate (ĸ=0,58).

Conclusion

Differentiation between early and locally advanced colon cancers with MDCT is challenging, particularly regarding nodal staging. This may have considerable clinical impact in the future if neoadjuvant treatment for locally advanced colon cancers becomes standard.