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3 - The Role of Magnetic Resonance Colonography and Transrectal Ultrasonography in Preoperative Staging of Rectal Cancer
Hülya Değirmenci, Muzaffer Başak, Hüseyin Özkurt, Alper Özel Esra Özer, Adil Baykan, Muharrem Öner
Objective: We aimed to compare the diagnostic yield of transrectal sonography and magnetic resonance imaging with rectal contrast for preoperative staging of rectal cancer.
Study Design: Sixteen patients (6 women and 10 men, mean age 56 years: range 23-80 years) underwent transrectal ultrasonography performed with 10 Mhz endoanal probe and MR imaging (1.5 T) using a body coil. After application of a mixture of 1500-2000 ml superparamagnctic iron oxide MR contrast.; Tl gradient, recall echo images in the coronal and axial planes were obtained. The results of the examinations were compared with histopathologic results.
Results: According to TNM system, histopathology showed 6 stage T2, 6 stage T3 and. 4 stage T4 tumors. There werent any patient with stage /. In all patients, transrectal sonography had an accuracy 87.5% for T staging, and the accu¬racy of MR imaging with rectal contrast in predicting T stage was 81%. The assesment of rectal wall penetration (Dukes classification A versus B) reveald a sensitivity, spesificity and accuracy of 100%, 67% and 87.5%, respectively for transrectal sonography and 100%, 50% and 81% for MR imaging.
Conclusion: Transrectal ultrasonography and MR imaging had very similar accuracy rate in preoperative staging of rectal cancer. In a highly experienced radiologist, transrectal sonography should be the first choice in prediction of T staging: due to lower cost, easy to perform and high accuracy rate. MR imaging should be prefer to transrectal sonography in highly located tumors of rectum where endoanal probe could not reach and in case of suspected of advanced disease.
Keywords: Colonography, magnetic resonance, Ultrasound, transrectal, Rectal cancer
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