Radiological Modalities in the Staging of Colorectal Tumors: New Perspectives for Increasing Accuracy
Part of the
Recent Results in Cancer Research
book series (RECENTCANCER, volume 142)
The purpose of this study was to evaluate the diagnostic accuracy of contrast-enhanced endorectal MRI for the staging of rectal adenoma versus rectal carcinoma in correlation to findings from biopsy and histopathology.
Ten volunteers and 20 patients underwent body-coil and endorectal MRI (1.5 T supraconducting unit) using plain, Tl-weighted (w) T2-w SE and TSEw sequences, a dynamic Gd-DTPA enhanced protocol (turboFLASH), and postcontrast Tl-w-SE sequences. Histopathological correlation via biopsy (n = 10) and surgical resection (n = 19) were conducted for all patients. An independent, two-observer, reader evaluation was performed and qualitative and quantitative data calculated.
In volunteers and all patients endorectal MRI reliably delineatel normal wall layers. Rectal adenomas (n = 7) were identified by a visualization of an intact muscularis mucosae, a homogeneous inner structure, and a significant contrast enhancement. T1 carcinomas (n = 4) were best identified in dynamic turboFLASH sequences by delineation of an intact muscularis propria. The visualization of contrast-enhancing tumor tissue was indicative of a T2 carcinoma (n = 4). All T3 (n = 3) and T4 (n = 2) carcinomas were correctly staged on dynamic and static MRI. The endorectal MRI stage agreed with the staging results from pathological study in 16 of 20 (80%) patients.
Endorectal surface coil MRI provides reliable data for the preoperative staging and evaluation of rectal lesions.
KeywordsAdenocarcinoma Adenoma Oncol Barium Gall
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