Value of MultiSlice Spiral Computed Tomography Compared with Transrectal Ultrasound in Preoperative Staging of Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Xiaojing ¹ , LAN Kai ¹ , WANG Xiaodong ² , Lv Donghao ¹ , YU Min ¹ , LI Zhengyan ³ , SHI Yingyu ⁴ , LI Li ²

1.West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, China;;
2.Department of Anal-Colorectal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;;
3.Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;;
4.Department of Sonography, West China Hospital, Sichuan University, Chengdu 610041, ChinaCorresponding Author: LI Li, E-mail: drlili116@126.com;

Corresponding author：

Keywords：

Rectal neoplasm; Transrectal ultrasound; Spiral computed tomography; Preoperative staging

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Objective 　To determine the role of multi-slice spiral computed tomography (MSCT) compared with transrectal ultrasound (TRUS) in preoperative staging of rectal cancer.
Methods 　Patients with rectal cancer from January to May 2009 in Department of Anal-Colorectal Surgery of West China Hospital were enrolled. All patients were preoperatively examined by both MSCT and TRUS for T and N staging, which were compared with postoperative pathological findings.
Results 　The study population consisted of 81 patients. Regarding depth of tumor invasion, the accuracy of TRUS (88.89%) was not significantly higher than that of MSCT (77.78%), P=0.168. Regarding lymph node metastasis, the result of MSCT was more accurate than that of TRUS (66.67% vs. 48.15%, P=0.034).
Conclusions 　Although TRUS remains the advantages in evaluating local invasion, the gap between MSCT and TRUS are significantly diminished. MSCT is superior to TRUS in evaluation of lymph node metastasis, however, further improvement on the diagnostic accuracies would be warranted in both modalities.

Citation： CHEN Xiaojing,LAN Kai,WANG Xiaodong,Lv Donghao,YU Min,LI Zhengyan,SHI Yingyu,LI Li. Value of MultiSlice Spiral Computed Tomography Compared with Transrectal Ultrasound in Preoperative Staging of Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(9): 702-705. doi: Copy

1.	汪晓东, 吕东昊, 曾天芳, 等. 多学科协作诊治模式下结直肠癌术前辅助检查系统的临床应用初步探索 [Ｊ]. 中国普外基础与临床杂志, 2009; 16(1): 7074.
2.	汪晓东, 何帆, 邓窈窕, 等. 直肠癌术前经直肠超声评估保肛或非保肛手术方案的临床前瞻性研究 [Ｊ]. 临床外科杂志, 2008; 16(11): 755757.
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5.	Hildebrandt U, Feifel G. Preoperative staging of rectal cancer by intrarectal ultrasound [Ｊ]. Dis Colon Rectum, 1985; 28(1): 4246.
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12.	Dinter DJ, Hofheinz RD, Hartel M, et al. Preoperative staging of rectal tumors: comparison of endorectal ultrasound, hydroCT, and highresolution endorectal MRI [Ｊ]. Onkologie, 2008; 31(5): 230235.
13.	Panzironi G, De Vargas Macciucca M, Manganaro L, et al. Preoperative locoregional staging of rectal carcinoma: comparison of MR, TRUS and Multislice CT. Personal experience [Ｊ]. Radiol Med, 2004; 107(4): 344355.
14.	Matsuoka H, Nakamura A, Masaki T, et al. Preoperative staging by multidetectorrow computed tomography in patients with rectal carcinoma [Ｊ]. Am J Surg, 2002; 184(2): 131135.
15.	Bipat S, Glas AS, Slors FJ, et al. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT and MR imaging-a metaanalysis [Ｊ]. Radiology, 2004; 232(3): 773783.
16.	Kim JC, Kim HC, Yu CS, et al. Efficacy of 3dimensional endorectal ultrasonography compared with conventional ultrasonography and computed tomography in preoperative rectal cancer staging [Ｊ]. Am J Surg, 2006; 192(1): 8997.
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20.	Dworak O. Number and size of lymph nodes and node metastases in rectal carcinomas [Ｊ]. Surg Endosc, 1989; 3(2): 9699.
21.	Mnig SP, Baldus SE, Zirbes TK, et al. Lymph node size and metastatic infiltration in colon cancer [Ｊ]. Ann Surg Oncol, 1999; 6(6): 579581.
22.	Gollub MJ, Schwartz LH, Akhurst T. Update on colorectal cancer imaging [Ｊ]. Radiol Clin North Am, 2007; 45(1): 85118.
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24.	汪晓东, 尹源, 陆玫竹, 等. 经直肠超声联合血清淀粉样蛋白A术前评估中低位直肠癌与手术决策的随机对照试验 [Ｊ]. 中国普外基础与临床杂志, 2009; 16(5): 407412.

1. 汪晓东, 吕东昊, 曾天芳, 等. 多学科协作诊治模式下结直肠癌术前辅助检查系统的临床应用初步探索 [Ｊ]. 中国普外基础与临床杂志, 2009; 16(1): 7074.
2. 汪晓东, 何帆, 邓窈窕, 等. 直肠癌术前经直肠超声评估保肛或非保肛手术方案的临床前瞻性研究 [Ｊ]. 临床外科杂志, 2008; 16(11): 755757.
3. Engelen SM, Beets GL, BeetsTan RG. Role of preoperative local and distant staging in rectal cancer [Ｊ]. Onkologie, 2007; 30(3): 141145.
4. Theoni RF. Colorectal cancer: crosssectional imaging for staging of primary tumor and detection of local recurrence [Ｊ]. AJR Am J Roentgenol, 1991; 156(5): 909915.
5. Hildebrandt U, Feifel G. Preoperative staging of rectal cancer by intrarectal ultrasound [Ｊ]. Dis Colon Rectum, 1985; 28(1): 4246.
6. Greene FL, Page DL, Fleming ID, et al Eds. AJCC cancer staging manual [M]. 6th ed. New York (NY): Springer Verlag, 2002: 113124.
7. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncologyrectal cancer, v.4.2008, http: //www.nccn.org/professionals/physician_gls/PDF/rectal.pdf.
8. 汪晓东, 吕东昊, 崔贝贝, 等. 术前经直肠超声评估直肠癌手术方案的随机对照试验 [Ｊ]. 中国循证医学杂志, 2008; 8(12): 10431046.
9. Kwok H, Bissett IP, Hill GL. Preoperative staging of rectal cancer [Ｊ]. Int J Colorectal Dis, 2000; 15(1): 920.
10. Rifkin MD, Ehrlich SM, Marks G. Staging of rectal carcinoma: prospective comparison of endorectal US and CT [Ｊ]. Radiology, 1989; 170(2): 319322.
11. Hünerbein M. Endorectal ultrasound in rectal cancer [Ｊ]. Colorectal Dis, 2003; 5(5): 402405.
12. Dinter DJ, Hofheinz RD, Hartel M, et al. Preoperative staging of rectal tumors: comparison of endorectal ultrasound, hydroCT, and highresolution endorectal MRI [Ｊ]. Onkologie, 2008; 31(5): 230235.
13. Panzironi G, De Vargas Macciucca M, Manganaro L, et al. Preoperative locoregional staging of rectal carcinoma: comparison of MR, TRUS and Multislice CT. Personal experience [Ｊ]. Radiol Med, 2004; 107(4): 344355.
14. Matsuoka H, Nakamura A, Masaki T, et al. Preoperative staging by multidetectorrow computed tomography in patients with rectal carcinoma [Ｊ]. Am J Surg, 2002; 184(2): 131135.
15. Bipat S, Glas AS, Slors FJ, et al. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT and MR imaging-a metaanalysis [Ｊ]. Radiology, 2004; 232(3): 773783.
16. Kim JC, Kim HC, Yu CS, et al. Efficacy of 3dimensional endorectal ultrasonography compared with conventional ultrasonography and computed tomography in preoperative rectal cancer staging [Ｊ]. Am J Surg, 2006; 192(1): 8997.
17. Birnbaum EH. What’s new in colon and rectal surgery [Ｊ]. J Am Coll Surg, 2006; 202(3): 485494.
18. Goertz RS, Fein M, Sailer M. Impact of biopsy on the accuracy of endorectal ultrasound staging of rectal tumors [Ｊ]. Dis Colon Rectum, 2008; 51(7): 11251129.
19. Karantanas AH, Yarmenitis S, Papanikolaou N, et al. Preoperative imaging staging of rectal cancer [Ｊ]. Dig Dis, 2007; 25(1): 2032.
20. Dworak O. Number and size of lymph nodes and node metastases in rectal carcinomas [Ｊ]. Surg Endosc, 1989; 3(2): 9699.
21. Mnig SP, Baldus SE, Zirbes TK, et al. Lymph node size and metastatic infiltration in colon cancer [Ｊ]. Ann Surg Oncol, 1999; 6(6): 579581.
22. Gollub MJ, Schwartz LH, Akhurst T. Update on colorectal cancer imaging [Ｊ]. Radiol Clin North Am, 2007; 45(1): 85118.
23. 汪晓东, 宋欢, 吕东昊, 等. 术前联合评估直肠上段癌与手术方案选择的随机对照试验 [Ｊ]. 中国普外基础与临床杂志, 2009; 16(4): 322326.
24. 汪晓东, 尹源, 陆玫竹, 等. 经直肠超声联合血清淀粉样蛋白A术前评估中低位直肠癌与手术决策的随机对照试验 [Ｊ]. 中国普外基础与临床杂志, 2009; 16(5): 407412.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of MultiSlice Spiral Computed Tomography Compared with Transrectal Ultrasound in Preoperative Staging of Rectal Cancer

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