Preoperative T staging of colon cancer using CT colonography with multiplanar reconstruction: new diagnostic criteria based on “bordering vessels”
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Preoperative T staging of colon cancer, in particular, for distinguishing T3 from T2 and T4, has been a challenge. The aim of this study was to evaluate newly developed criteria for preoperative T staging of colorectal cancer using computed tomography colonography (CTC) with multiplanar reconstruction (MPR), based on the spatial relationship of tumors and “bordering vessels,” that is, marginal vessels that are detectable by multi-detector row CT with MPR.
A total of 172 patients with colon and upper rectal cancer who underwent preoperative CTC and surgery between August 2011 and September 2013 were included. Preoperative T staging using the new criteria was performed prospectively and compared with pathologic results.
Sensitivity, specificity, and accuracy of T staging by CTC using the new criteria were 63%, 80%, and 77% for T2 (n = 30); 72%, 94%, and 81% for T3 (n = 95); and 79%, 99%, and 97% for T4a (n = 14), respectively. Positive predictive value for T3 was 93%, indicating that a T3 diagnosis by CTC is precise. In addition, negative predictive value for pathological T4a was 98%, indicating that a “not T4a” diagnosis by CTC is also precise.
Our newly developed criteria are useful for preoperative T staging, particularly for distinguishing T3 from T2 and T4.
KeywordsPreoperative T staging CT colonography Multiplanar reconstruction (MPR) Colon cancer
The authors thank the former staff of our division, Moriya M., Akasu T., Fujita S., Yamamoto S, and Ochiai H. The authors also thank all of their colleagues and nurses who took care of the patients.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Union for International Cancer Control (UICC), Brierley JD, Gospodarowicz MK, Wittekind C (eds) (2017) TNM classification of malignant tumours eight edition. John Wiley & Sons, Ltd., New JerseyGoogle Scholar
- 3.Inomata M, Katayama H, Mizusawa J, Watanabe M, Sugihara K, Konishi F et al (2015) A randomized controlled trial to evaluate laparoscopic versus open complete mesocolic excision (CME) for stage II, III colorectal cancer (CRC): first efficacy results from Japan Clinical Oncology Group Study JCOG0404. J Clin Oncol 33:abstr 656CrossRefGoogle Scholar
- 4.Kitano S, Inomata M, Mizusawa J, Katayama H, Watanabe M, Yamamoto S, Ito M, Saito S, Fujii S, Konishi F, Saida Y, Hasegawa H, Akagi T, Sugihara K, Yamaguchi T, Masaki T, Fukunaga Y, Murata K, Okajima M, Moriya Y, Shimada Y (2017) Survival outcomes following laparoscopic versus open D3 dissection for stage II or III colon cancer (JCOG0404): a phase 3, randomised controlled trial. Lancet Gastroenterol Hepatol 2:261–268CrossRefGoogle Scholar
- 6.Karoui M, Rullier A, Luciani A, Bonnetain F, Auriault ML, Sarran A, Monges G, Trillaud H, le Malicot K, Leroy K, Sobhani I, Bardier A, Moreau M, Brindel I, Seitz JF, Taieb J (2015) Neoadjuvant FOLFOX 4 versus FOLFOX 4 with cetuximab versus immediate surgery for high-risk stage II and III colon cancers: a multicentre randomised controlled phase II trial--the PRODIGE 22--ECKINOXE trial. BMC Cancer 15:511CrossRefGoogle Scholar
- 15.Miyake M, Iinuma G, Taylor SA, Halligan S, Morimoto T, Ichikawa T, Tomimatsu H, Beddoe G, Sugimura K, Arai Y (2013) Comparative performance of a primary-reader and second-reader paradigm of computer-aided detection for CT colonography in a low-prevalence screening population. Jpn J Radiol 31:310–319CrossRefGoogle Scholar