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Endoscopic ultrasound and magnetic resonance imaging forre-staging rectal cancer after radiotherapy

2009; Baishideng Publishing Group; Volume: 15; Issue: 44 Linguagem: Inglês

10.3748/wjg.15.5563

2219-2840

G. Mezzi, Paolo Giorgio Arcidiacono, Silvia Carrara, Francesco Perri, Maria Chiara Petrone, Francesco De Cobelli, Simone Gusmini, C. Staudacher, Alessandro Del Maschio, Pier Alberto Testoni,

Advanced Radiotherapy Techniques

AIM:To compare the sensitivity and specificity of two imaging techniques, endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI), in patients with rectal cancer after neoadjuvant chemoradiation therapy.And we compared EUS and MRI data with histological findings from surgical specimens.METHODS: Thirty-nine consecutive patients (51.3% Male; mean age: 68.2 ± 8.9 years) with histologically confirmed distal rectal cancer were examined for staging.All patients underwent EUS and MRI imaging before and after neoadjuvant chemoradiation therapy. RESULTS:After neoadjuvant chemoradiation, EUS and MRI correctly classified 46% (18/39) and 44% (17/39) of patients, respectively, in line with their histological T stage (P > 0.05).These proportions were higher for both techniques when nodal involvement was considered: 69% (27/39) and 62% (24/39).When patients were sorted into T and N subgroups, the diagnostic accuracy of EUS was better than MRI for patients with T0-T2 (44% vs 33%, P > 0.05) and N0 disease (87% vs 52%, P = 0.013).However, MRI was more accurate than EUS in T and N staging for patients with more advanced disease after radiotherapy, though these differences did not reach statistical significance.CONCLUSION: EUS and MRI are accurate imaging techniques for staging rectal cancer.However, after neoadjuvant RT-CT, the role of both methods in the assessment of residual rectal tumors remains uncertain.