Preoperative staging of rectal cancer with MRI: correlation with pathologic staging

Journal of Coloproctology - Tập 35 - Trang 77-82 - 2015
Soraia Filipa Macado Abreu1,2, Sandra Fátima Fernandes Martins1,2,3
1Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
2ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
3Surgery Department, Hospitalar Center of Trás-os-Montes e Alto Douro, Distrito de Vila Real, Portugal

Tóm tắt

Abstract Introduction An accurate preoperative rectal cancer staging is crucial to the correct management of the disease. Despite great controversy around this issue, pelvic magnetic resonance (RM) is said to be the imagiologic standard modality. This work aimed to evaluate magnetic resonance accuracy in preoperative rectal cancer staging comparing with the anatomopathological results. Methods We calculated sensibility, specificity, positive (VP positive) and negative (VP negative) predictive values for each T and N. We evaluated the concordance between both methods of staging using the Cohen weighted K (K w), and through ROC curves, we evaluated magnetic resonance accuracy in rectal cancer staging. Results 41 patients met the inclusion criteria. We achieved an efficacy of 43.9% for T and 61% for N staging. The respective sensibility, specificity, positive and negative predictive values are 33.3%, 94.7%, 33.3% and 94.7% for T1; 62.5%, 32%, 37.0% and 57.1% for T2; 31.8%, 79%, 63.6% and 50% for T3 and 27.8%, 87%, 62.5% and 60.6% for N. We obtained a poor concordance for T and N staging and the anatomopathological results. The ROC curves indicated that magnetic resonance is ineffective in rectal cancer staging. Conclusion Magnetic resonance has a moderate efficacy in rectal cancer staging and the major difficulty is in differentiating T2 and T3.

Tài liệu tham khảo

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Journal of Coloproctology

Tập 35

77-82

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