Restaging locally advanced rectal cancer by different imaging modalities after preoperative chemoradiation: A comparative study

Ram Dickman*, Yulia Kundel, Rachel Levy-Drummer, Ofer Purim, Nir Wasserberg, Eyal Fenig, Aaron Sulkes, Baruch Brenner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background: To compare the accuracy of different imaging modalities, alone and in combination in predicting findings at surgery after preoperative chemoradiation for locally advanced rectal cancer. Methods: Following chemoradiation, tumors were reclassified on the basis of findings on pelvic computed tomography (CT) (94 patients), endorectal ultrasonography (EUS) (138 patients) alone or by both CT and EUS (80 patients). The ability of the imaging modalities, to predict the pathologic T status, N status, and TNM stage at surgery was evaluated and compared. Results: Mean age of the patients was 64.5 years (range 28-88 years); 55% were male. CT and EUS combined had a positive predictive value of 20% for pathologic pT1 stage, 29% for pT1, 29% for pT2, and 58% for pT3. Predictive values for the operative TNM stage were 50% for stage I, 45% for stage II, and 31% for stage III. These values did not exceed those for each modality alone.Conclusion: The performance of preoperative CT and EUS in predicting the T and TNM stage of rectal cancer at surgery is poor. Neither modality alone nor the two combined is sufficiently accurate to serve as the basis for decisions regarding treatment modification.

Original languageEnglish
Article number278
JournalRadiation Oncology
Volume8
Issue number1
DOIs
StatePublished - 29 Nov 2013

Keywords

  • Computed tomography
  • Endorectal ultrasonography
  • Locally advanced rectal cancer
  • Preoperative chemoradiation
  • Restaging

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