Diagnosis values of CT and MRI scans on preoperative T and N stagings of rectal carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 YANG Renbao , LI Liang , ZHANG Jun , LI Wenbo , LU Jun

Department of General Surgery, Hefei Second People’s Hospital, Hefei 230001, P. R. China;

Corresponding?author：

YANG Renbao, Email: yangrenbao20@163.com

Keywords：

rectal carcinoma; preoperative staging; spiral CT; magnetic resonance imaging

DOI：

10.7507/1007-9424.201709021

Video：

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Objective To compare diagnosis values of computed tomography (CT) and magnetic resonance imaging (MRI) in preoperative staging of rectal carcinoma. Methods The imaging data of 81 patients with rectal carcinoma from January 2013 to January 2017 in the Hefei Second People’s Hospital were retrospectively analyzed. Based on the postoperative pathological results, the diagnostic accordance rates of CT and MRI on the T staging and N staging were calculated. Results The sensitivities of the CT and MRI on the preoperative T staging of rectal carcinoma were 69.1% (56/81) and 82.5% (52/63), the difference was not statistically significant (χ²=3.396, P=0.065), the Kappa values was 0.521 and 0.371, respectively, the MRI on the T staging was in a good agreement with the pathological diagnosis. The sensitivitie of the T1-2, T3, and T4 stagings with CT was 70.0%, 66.7%, and 72.0%, respectively, with MRI was 83.3%, 83.3%, and 81.0%, respectively, which had no significant difference respectively between the CT and the MRI. The areas under the receiver operating characteristic curve of the T1-2, T3, and T4 stagings with the CT and MRI were 0.809, 0.689, 0.798 and 0.897, 0.826, 0.869, respectively. The sensitivities of the CT and MRI on the preoperative N staging of rectal carcinoma were 59.3% (48/81) and 65.1% (41/63), the difference was not statistically significant (χ²=0.509, P=0.476), the Kappa values were 0.371 and 0.463, respectively. The sensitivities of the N0, N1, N2 stagings with CT were 64.7%, 45.5%, 64.0%, with MRI were 70.3%, 63.2%, 72.5%, which had no significant difference respectively between the CT and the MRI. Conclusions Results of in this study show that MRI is superior to CT for judgment of tumor infiltration. Neither CT nor MRI is able to provide satisfactory assessment of lymph node metastasis.

Citation： YANG Renbao, LI Liang, ZHANG Jun, LI Wenbo, LU Jun. Diagnosis values of CT and MRI scans on preoperative T and N stagings of rectal carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(4): 433-437. doi: 10.7507/1007-9424.201709021 Copy

1.	Lee DJ, Sagar PM, Sadadcharam G, et al. Advances in surgical management for locally recurrent rectal cancer: How far have we come? World J Gastroenterol, 2017, 23(23): 4170-4180.
2.	Engin G, Sharifov R. Magnetic resonance imaging for diagnosis and neoadjuvant treatment evaluation in locally advanced rectal cancer: A pictorial review. World J Clin Oncol, 2017, 8(3): 214-229.
3.	Benson AB 3rd, Venook AP, Bekaii-Saab T, et al. Rectal cancer, version 2.2015. J Natl Compr Canc Netw, 2015, 13(6): 719-728.
4.	肖毅. 低位直腸癌的外科治療選擇. 腹部外科, 2014, 27(4): 236-238.
5.	Garisto JD, Klotz L. Active surveillance for prostate cancer: how to do it right. Oncology (Williston Park), 2017, 31(5): 333-340.
6.	黃蓉, 張路檸, 肖巍魏, 等. 291 例局部進展期直腸癌術前新輔助放化療的臨床意義分析. 中華放射腫瘤學雜志, 2015, 24(2): 143-148.
7.	彭海花, 王成濤, 余昕, 等. 局部晚期直腸癌術前同期放化療達 pCR 者預后分析. 中華放射腫瘤學雜志, 2016, 25(10): 1079-1082.
8.	Xu D, Ju HX, Qian CW, et al. The value of TRUS in the staging of rectal carcinoma before and after radiotherapy and comparison with the staging postoperative pathology. Clin Radiol, 2014, 69(5): 481-484.
9.	呂東昊, 高強, 汪曉東, 等. 多層螺旋 CT 聯合不同炎性反應指標對直腸癌外科決策的隨機對照研究. 中國普外基礎與臨床雜志, 2009, 16(10): 851-855.
10.	田博, 楊得振, 賈勇, 等. CT、MRI 影像診斷對直腸癌臨床術前分期價值研究. 中國 CT 和 MRI 雜志, 2015, 13(11): 108-110, 114.
11.	王亞寧, 時高峰, 杜煜. 比較 MSCT 與 MRI 在結直腸癌術前分期診斷中的價值. 中國醫學影像技術, 2011, 27(4): 772-775.
12.	Shida D, Iinuma G, Komono A, et al. Preoperative T staging using CT colonography with multiplanar reconstruction for very low rectal cancer. BMC Cancer, 2017, 17(1): 764.
13.	Nerad E, Lahaye MJ, Maas M, et al. Diagnostic accuracy of CT for local staging of colon cancer: a systematic review and meta-analysis. AJR Am J Roentgenol, 2016, 207(5): 984-995.
14.	曾令延, 魏文洲. 64 層螺旋 CT 仿真內鏡在結直腸癌的檢測和術前分期中的作用. 醫學影像學雜志, 2013, 23(2): 268-270, 274.
15.	魯家賢, 童鐵軍, 董孫根, 等. 結直腸癌多層螺旋 CT 浸潤征像與病理預后因子的關系. 浙江醫學, 2015, 34(6): 469-472.
16.	Hellstr?m M, Svensson MH, Lasson A. Extracolonic and incidental findings on CT colonography (virtual colonoscopy). AJR Am J Roentgenol, 2004, 182(3): 631-638.
17.	Li XT, Zhang XY, Sun YS, et al. Evaluating rectal tumor staging with magnetic resonance imaging, computed tomography, and endoluminal ultrasound: A meta-analysis. Medicine (Baltimore), 2016, 95(44): e5333.
18.	唐娜, 尚乃艦, 張紅霞. 3.0T 高分辨率 MRI 在直腸癌術前 T 分期中的價值. 中國臨床醫學影像雜志, 2016, 27(8): 562-564, 569.
19.	甘銳, 余文毅. CT、MRI 成像用于直腸癌術前分期診斷中的價值對比研究. 四川醫學, 2016, 37(6): 678-680.
20.	Nerad E, Lambregts DM, Kersten EL, et al. MRI for local staging of colon cancer: can MRI become the optimal staging modality for patients with colon cancer? Dis Colon Rectum, 2017, 60(4): 385-392.
21.	叢冠寧, 秦明偉, 賀丹, 等. 高分辨率 MRI 對直腸癌 TNM 分期及環周切緣的評估. 中國普外基礎與臨床雜志, 2010, 17(9): 894-900.
22.	Beets-Tan RG, Beets GL, Vliegen RF, et al. Accuracy of magnetic resonance imaging in prediction of tumour-free resection margin in rectal cancer surgery. Lancet, 2001, 357(9255): 497-504.
23.	任鏡清, 薛福龍, 劉少杰, 等. 淋巴結轉移度及腫瘤 N 分期對Ⅲ期結直腸癌復發或轉移的預測價值. 中華胃腸外科雜志, 2015, 18(6): 553-557.

1. Lee DJ, Sagar PM, Sadadcharam G, et al. Advances in surgical management for locally recurrent rectal cancer: How far have we come? World J Gastroenterol, 2017, 23(23): 4170-4180.
2. Engin G, Sharifov R. Magnetic resonance imaging for diagnosis and neoadjuvant treatment evaluation in locally advanced rectal cancer: A pictorial review. World J Clin Oncol, 2017, 8(3): 214-229.
3. Benson AB 3rd, Venook AP, Bekaii-Saab T, et al. Rectal cancer, version 2.2015. J Natl Compr Canc Netw, 2015, 13(6): 719-728.
4. 肖毅. 低位直腸癌的外科治療選擇. 腹部外科, 2014, 27(4): 236-238.
5. Garisto JD, Klotz L. Active surveillance for prostate cancer: how to do it right. Oncology (Williston Park), 2017, 31(5): 333-340.
6. 黃蓉, 張路檸, 肖巍魏, 等. 291 例局部進展期直腸癌術前新輔助放化療的臨床意義分析. 中華放射腫瘤學雜志, 2015, 24(2): 143-148.
7. 彭海花, 王成濤, 余昕, 等. 局部晚期直腸癌術前同期放化療達 pCR 者預后分析. 中華放射腫瘤學雜志, 2016, 25(10): 1079-1082.
8. Xu D, Ju HX, Qian CW, et al. The value of TRUS in the staging of rectal carcinoma before and after radiotherapy and comparison with the staging postoperative pathology. Clin Radiol, 2014, 69(5): 481-484.
9. 呂東昊, 高強, 汪曉東, 等. 多層螺旋 CT 聯合不同炎性反應指標對直腸癌外科決策的隨機對照研究. 中國普外基礎與臨床雜志, 2009, 16(10): 851-855.
10. 田博, 楊得振, 賈勇, 等. CT、MRI 影像診斷對直腸癌臨床術前分期價值研究. 中國 CT 和 MRI 雜志, 2015, 13(11): 108-110, 114.
11. 王亞寧, 時高峰, 杜煜. 比較 MSCT 與 MRI 在結直腸癌術前分期診斷中的價值. 中國醫學影像技術, 2011, 27(4): 772-775.
12. Shida D, Iinuma G, Komono A, et al. Preoperative T staging using CT colonography with multiplanar reconstruction for very low rectal cancer. BMC Cancer, 2017, 17(1): 764.
13. Nerad E, Lahaye MJ, Maas M, et al. Diagnostic accuracy of CT for local staging of colon cancer: a systematic review and meta-analysis. AJR Am J Roentgenol, 2016, 207(5): 984-995.
14. 曾令延, 魏文洲. 64 層螺旋 CT 仿真內鏡在結直腸癌的檢測和術前分期中的作用. 醫學影像學雜志, 2013, 23(2): 268-270, 274.
15. 魯家賢, 童鐵軍, 董孫根, 等. 結直腸癌多層螺旋 CT 浸潤征像與病理預后因子的關系. 浙江醫學, 2015, 34(6): 469-472.
16. Hellstr?m M, Svensson MH, Lasson A. Extracolonic and incidental findings on CT colonography (virtual colonoscopy). AJR Am J Roentgenol, 2004, 182(3): 631-638.
17. Li XT, Zhang XY, Sun YS, et al. Evaluating rectal tumor staging with magnetic resonance imaging, computed tomography, and endoluminal ultrasound: A meta-analysis. Medicine (Baltimore), 2016, 95(44): e5333.
18. 唐娜, 尚乃艦, 張紅霞. 3.0T 高分辨率 MRI 在直腸癌術前 T 分期中的價值. 中國臨床醫學影像雜志, 2016, 27(8): 562-564, 569.
19. 甘銳, 余文毅. CT、MRI 成像用于直腸癌術前分期診斷中的價值對比研究. 四川醫學, 2016, 37(6): 678-680.
20. Nerad E, Lambregts DM, Kersten EL, et al. MRI for local staging of colon cancer: can MRI become the optimal staging modality for patients with colon cancer? Dis Colon Rectum, 2017, 60(4): 385-392.
21. 叢冠寧, 秦明偉, 賀丹, 等. 高分辨率 MRI 對直腸癌 TNM 分期及環周切緣的評估. 中國普外基礎與臨床雜志, 2010, 17(9): 894-900.
22. Beets-Tan RG, Beets GL, Vliegen RF, et al. Accuracy of magnetic resonance imaging in prediction of tumour-free resection margin in rectal cancer surgery. Lancet, 2001, 357(9255): 497-504.
23. 任鏡清, 薛福龍, 劉少杰, 等. 淋巴結轉移度及腫瘤 N 分期對Ⅲ期結直腸癌復發或轉移的預測價值. 中華胃腸外科雜志, 2015, 18(6): 553-557.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis values of CT and MRI scans on preoperative T and N stagings of rectal carcinoma

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