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Accuracy of high-resolution magnetic resonance imaging in preoperative staging of rectal cancer
Annals of Surgical Oncology, 07/27/09

Akasu T et al. – In a study to evaluate accuracy of high–resolution magnetic resonance imaging (HRMRI) for preoperative staging of rectal cancer, it appears that HRMRI was moderately accurate for prediction of mesorectal lymph node metastasis and highly accurate regarding transmural invasion depth, and mesorectal fascia and lateral pelvic node involvement. HRMRI appears useful for preoperative decision–making in rectal cancer treatment.

Methods

104 pts with primary rectal cancer were examined with HRMRI and underwent radical surgery.
Transmural invasion depth and lymph node metastasis were assessed prospectively and classified according to the American Joint Committee on Cancer (AJCC) tumor–node–metastasis (TNM) system by both HRMRI and histopathology, and results were compared.
Criteria for mesorectal and lateral pelvic lymph node involvement were short–axis diameters of ≥5 mm and ≥4 mm, respectively.

Results

There were 15 pT1, 25 pT2, 50 pT3, and 14 pT4 tumors.
Overall accuracy rate for transmural invasion depth was 84%.
The mesorectal fascia could be visualized in 98% of pts.
23 pts had mesorectal fascia involvement and overall accuracy rate was 96% (sensitivity, 96%; specificity, 96%).
53 pts had mesorectal lymph node metastasis and overall accuracy rate was 74% (sensitivity, 83%; specificity, 64%).
Lateral pelvic lymph node metastasis was observed in 15 pts and overall accuracy rate was 87% (sensitivity, 87%; specificity, 87%).

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