Research advances in preoperative staging of gastric cancer / 中国肿瘤临床

Accurate preoperative staging of gastric cancer is of great significance for choosing an optimal therapeutic schedule and for evaluating the prognosis. Accurate preoperative preparation can avoid unnecessary treatment and help with selecting optimal treat-ment modalities. In recent years, the preoperative staging of gastric cancer has been greatly improved owing to the use of diagnostic methods such as endoscopic ultrasonography, multi-slice spiral computed tomography, positron emission computed tomography, and staging laparoscopy, among other such modalities. However, all diagnostic methods are associated with advantages and limitations. Thus, a combination of various diagnostic modalities is essential for accurate preoperative staging. This paper reviews the research progress in the aforementioned diagnostic methods for preoperative staging.

The application value of DCE-MRI in the preoperative TN staging of rectal cancer / 实用放射学杂志

Objective To study the application of dynamic contrast-enhanced MRI (DCE-MRI)in preoperative TN staging of rectal cancer. Methods Seventy-two patients with rectal cancer confirmed by surgery and pathology underwent preoperative conventional MRI and DCE-MRI.The consistencies between conventional MRI and pathology,conventional MRI combined with DCE-MRI and pathology in diagnosing the TN staging were analyzed retrospectively.The quantitative parameters of DCE-MRI including Ktrans,Veand Kepwere measured to analyze the correlation with T staging and lymph nodes metastasis.Results The accuracy of conventional MRI and conventional MRI combined with DCE-MRI in diagnosing the T staging were 72.2% and 84.7%,respectively,in diagnosing the N staging were 65.3% and 77.8%, respectively.The DCE-MRI quantitative parameters (Ktransvalue,Vevalue and Kepvalue)were positively related to the T staging and lymph nodes metastasis(P<0.05).Conclusion DCE-MRI can improve the accuracy of the preoperative TN staging of rectal cancer. DCE-MRI quantitative parameters of Ktrans,Ve,Kepvalues can help to determine T staging and lymph node properties of rectal cancer.

Preoperative evaluation and application development of rectal cancer based on MRI / 中国医学影像技术

MRI is the first choice for preoperative evaluation of rectal cancer.It can not only provide high accuracy for T and N stage,but can also apply important factors related to the prognosis,such as extramural depth,extramural venous invasion and circumferential resection margin.Moreover,it is also promising for predicting therapeutic effects of neoaduvant chemoradiotherapy.MRI preoperative evaluation indexes and new techniques in rectal cancer were reviewed in this paper.

The value of multimodal MRI in preoperative staging and grading of endometrial carcinoma / 实用放射学杂志

Objective To analyze the imaging features of endometrial carcinoma derived from multimodal MRI.Methods MRI scan was performed in 45 patients with biopsy-proved endometrial carcinoma,including conventional MRI,diffusion weighted imaging(DWI),dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI),and time-signal curve (TIC).Results The diagnosis rate of DCE-MRI combined with DWI was 93.3%, and that of conventional MRI was 77.8%.Tumor differentiation was negatively correlated with ADC and rADC, and significant difference was found between G2 and G3 as well as G1 and G3 (both P0.05).Of the 45 cases, 43 showed TIC type Ⅰ and type Ⅱ, and 2 showed TIC type Ⅲ, while the normal myometrium was mainly type Ⅲ curve.The difference of signal intensity of each phase (D), and enhancement rate (ER) of the lesions were lower than those of the normal myometrium.The difference was statistically significant at the phase of >30 s(P<0.05),the peak time of the former was (50±10) s.Conclusion Multimodal MRI is of great value in preoperative staging and grading of endometrial carcinoma.

Application of Real-time Ultrasound Elastography for Preoperative Staging of Rectal Cancer / 中国医科大学学报

Objective To explore the role of real-time ultrasound elastography (RUE) in the staging of rectal cancer.Methods We retrospectively analyzed 41 cases of rectal cancer by both double plane transrectal conventional ultrasonography (CU) and RUE and comparatively assessed elasticity scores and strain ratios (SR) of the tumor along with postoperative pathological staging results.Results The accuracy of CU for preoperative staging of rectal tumors was 80.49％.There were significant differences between the elasticity scores and strain ratios of the T1 stage and T2,T3,and T4 stages,and also in elasticity scores and strain ratios of the T4 stage and T2 and T3 stages of rectal cancer by using RUE (P ＜ 0.05).Taking the elasticity score of 3 points as the optimal ritical value in the diagnosis of the T1 stage of rectal cancer,the sensitivity,specificity,positive predictive value,and negative predictive value were 66.67％,96.88％,85.71％,and 91.18％ respectively.Condusion Endorectal RUE can assess the elastic stiffness of rectal cancer,and it helps in the preoperative staging of rectal cancer.

Preoperative evaluation and application development of rectal cancer based on MRI / 中国医学影像技术

MRI is the first choice for preoperative evaluation of rectal cancer.It can not only provide high accuracy for T and N stage,but can also apply important factors related to the prognosis,such as extramural depth,extramural venous invasion and circumferential resection margin.Moreover,it is also promising for predicting therapeutic effects of neoaduvant chemoradiotherapy.MRI preoperative evaluation indexes and new techniques in rectal cancer were reviewed in this paper.

Clinical application value of ultrasonic endoscopy and gastrointestinal ultrasonic contrast in preoperative staging of gastric carcinoma / 重庆医学

Objective To investigate the imaging features and preoperative staging value of ultrasonic endoscopy and gastrointestinal ultrasonic contrast in the gastric carcinoma examination.Methods One hundred and sixty eight patients with gastric carcinoma verified by operation and pathology in our hospital from October 2010 to October 2015 werecollected.Then their imageological data including ultrasonic endoscopy and gastrointestinal ultrasonic contrast examinations were retrospectively analyzed and compared with the postoperative pathological results.Results The accuracy rate of preoperative T staging in ultrasonic endoscopy was significantly higher than that of gastrointestinal ultrasonic contrast,the difference had statistical significance(P＜0.05);the accuracy rate of preoperative N/M staging in gastrointestinal ultrasonic contrast was s1gnificantly higher than that in ultrasonic endoscopy,the difference had statistical significance(P＜0.05).Conclusion Ultrsonic endoscopy and gastrointestinal ultrasonic contrast have different advantages and values in preoperative staging:ultrasonic endoscopy has higher accuracy rate in the diagnosis of primary gastric carcinoma;gastrointestinal ultrasonic contrast is better in diagnosing metastasis of gastric carcinoma,moreover which shows the consistency with postoperative pathological staging.

A Comparative Study on Diagnostic Value of CT and MRI in Preoperative Local Staging for Rectal Cancer / 昆明医科大学学报

Objective The purpose of this article was to investigate the diagnostic value of CT and MRI in preoperative local staging for rectal cancer patients. Methods Forty rectal cancer patients were enrolled,and their preoperative CT and MRI staging and pathological staging in T and N were compared. Results The total diagnostic accordance rate of CT staging in T was 57.5%(31/40),among which the accordance rate of T1-2,T3 and T4 was 87.5%(35/40),83.25%(33/40) and 70%(28/40),respectively. The total diagnostic accordance rate of MRI staging in T was 77.5%(31/40), among which the accordance rate of T1-2, T3 and T4 was 92.5%(37/40), 77.5%(31/40) and 85%(34/40),respectively. The differences were tested by Chi-square test,and there were no significant differences between the two groups in T staging. The sensitivity of T staging by CT was 77.78%(7/9) for T1-2, 75% (12/16) for T3 and 93.33% (14/15) for T4. Compared with CT, the sensitivity of MRI was 66.67%(6/9) for T1-2, 81.25%(13/16) for T3 and 80%(12/15) for T4, and there were no significant differences between the two groups. The specificity of T staging by CT was 90.32% (28/31) for T1-2, 45.83%(11/24) for T3 and 96%(24/25) for T4. Compared with CT, the specificity of MRI was 100% (31/31) for T1-2, 75% (18/24) for T3 and 88%(22/25) for T4, and there was a significant difference in T3 specificity ( <0.05) . The total diagnostic accordance rate of CT staging in N was 82.5% (33/40),among which the rate of N- and N+was 82.5%(33/40) and 82.5%(33/40), respectively. The total diagnostic accordance rate of MRI staging in N was 62.5%(25/40),among which the rate of N- and N+was 62.5% (25/40) and 62.5%(25/40), respectively. There were significant differences between the two groups in pelvic N staging ( < 0.05) . The sensitivity of N staging by CT was 75.00%for N- (18/24) and 81.25%(13/16) for N+. Compared with CT,the sensitivity of MRI was 75.00%(18/24) for N- and 43.75%(7/16) for N+,and there were significant differences between the two groups ( <0.05) . The specificity of N staging by CT was 81.25% (13/16) for N- and 83.33%(20/24) for N+. Compared with CT, the specificity of MRI was 43.75% (7/16) for N- and 75.00%(18/24) for N+, and there were significant differences between the two groups ( <0.05) . Conclusion MRI has a high reliability in diagnosing rectal cancer with penetrating through the muscularis propria into the placenta percreta or not, but CT is superior in diagnosing the lymphonodus metastasis.

Preoperative Evaluation of Lower Rectal Cancer by Pelvic MR with and without Gel Filling

PURPOSE: To assess the usefulness of rectal filling using ultrasonographic gel in patients with lower rectal cancer. MATERIALS AND METHODS: Twenty five patients with lower rectal cancer were enrolled. High resolution pelvic MR was performed twice before and after gel filling. Independently and retrospectively, two radiologists reviewed each set of MR images using five-grade scales for sphincter involvement, CRM (circumferential resection margin) involvement and depiction of the tumor. Same two radiologists retrospectively performed consensus review of each set of MR images for tumor distance from the anal verge and T&N staging. RESULTS: Tumor depiction scores from MR with gel filling were significantly higher than those of MR without distention (p0.05). Distance from the anal verge was significantly different between MR with gel filling and rigid endoscopy (6.8 +/- 1.6 cm vs. 5.8 +/- 1.6 cm, p=0.001). There were no significant differences between pathological staging and MR staging with or without gel filling. CONCLUSION: MR with gel filling improved tumor depiction. And also MR with gel filling revealed same ability for the predictions of CRM or sphincter invasion in patients with lower rectal cancer, comparing with MR without gel filling.

Application value of MDCT double period enhanced scanning with low-tension water enteroclysis pres-entations for colon cancer preoperative staging / 实用肿瘤学杂志

Objective This paper is mainly to discuss accuracy and clinical application value of MDCT double-period enhanced scanning with low -tension water enteroclysis for colon cancer preoperative TNM stag-ing.Methods Sixty-two colon cancer patients with complete images and pathological data were selected in our hospital from January 2012 to May 2013 .We retrospectively analyzed CT image changes of the tumor location ,the extent of tumor invasion,the surrounding fat space,lymph node metastasis and distant metastasis.We compared them with postoperative pathology to prove the accuracy of MDCT double -period enhanced scanning with low -tension water enteroclysis.Results The results showed that its accuracy rate reached to 90.32%(56/62)in co-lon cancer preoperative Stage T,80.64%(50/62)in Stage N,and 100%(62/62)in Stage M respectively.Con-clusions MDCT double-period enhanced scanning with low -tension water enteroclysis can accurately display the site of colon cancer and determine the scope of tumor invasion ,lymph node metastasis and distant metastasis , and give more precise diagnosis of colon cancer and preoperative staging assessments .In conclusion , it can be used as the preferable method of preoperative examination in the colon cancer .

F18-fluorodeoxyglucose-positron emission tomography and computed tomography is not accurate in preoperative staging of gastric cancer / 대한외과학회지

PURPOSE: To investigate the clinical benefits of F18-fluorodeoxyglucose-positron emission tomography and computed tomography (18F-FDG-PET/CT) over multi-detector row CT (MDCT) in preoperative staging of gastric cancer. METHODS: FDG-PET/CT and MDCT were performed on 78 patients with gastric cancer pathologically diagnosed by endoscopy. The accuracy of radiologic staging retrospectively was compared to pathologic result after curative resection. RESULTS: Primary tumors were detected in 51 (65.4%) patients with 18F-FDG-PET/CT, and 47 (60.3%) patients with MDCT. Regarding detection of lymph node metastasis, the sensitivity of FDG-PET/CT was 51.5% with an accuracy of 71.8%, whereas those of MDCT were 69.7% and 69.2%, respectively. The sensitivity of 18F-FDG-PET/CT for a primary tumor with signet ring cell carcinoma was lower than that of 18F-FDG-PET/CT for a primary tumor with non-signet ring cell carcinoma (35.3% vs. 73.8%, P < 0.01). CONCLUSION: Due to its low sensitivity, 18F-FDG-PET/CT alone shows no definite clinical benefit for prediction of lymph node metastasis in preoperative staging of gastric cancer.

Application of endoscopic ultrasonography in preoperative staging of esophageal cancer and cardia cancer / 国际外科学杂志

Objective To compare T and N staging of esophageal and cardia cancer by endoscopic ultrasonography (EUS) and computed tomography (CT) before operation, and to evaluate clinical value of EUS.Methods Twenty-eight patients received examination of EUS and CT preoperatively, and the T and N staging was determined. The accuracy rates of both T, N staging were compared by the postoperative pathological results, at the same time, the accuracy rates of lymph node metastasis were compared, and the value of application of EUS was investigated. Results In the twenty-eight cases, the accuracy rates of EUS were higher than that of CT by 89.3% ( 25/28 ) to 46.4% ( 13/28 ) in T staging. And the difference had statistical significance( P = 0. 004 ,P ＜ 0.01 ). The N stagings of both were 82.1% (23/28) and 50.0% ( 14/28), and the difference had statistical significance ( P = 0. 035, P ＜ 0. 05 ). The accuracy rates of lymph node metastasis of both were 88.7% and 72.2% respectively, and the difference had statistical significance (χ2 = 7.031,P = 0.008, P ＜ 0. 01 ). Conclusions EUS has very important value in preoperative staging for esophageal cancer and cardia cancer, and the T staging of EUS is better than that of CT. The short axis and the ratio of short to long axis (S/L) combined with the lymph node ultrasonography image can improve the accuracy rates of lymph node metatsasis and N staging.

Diagnostic Usefulness of Routinely Performed Preoperative Chest Computed Tomography for Colorectal Cancer

PURPOSE: The most common site of metastases in colorectal cancer (CRC) is the liver, and the second common site is the lung (10-20%). Preoperative staging for CRC is very important. The aim of this study was to assess the usefulness of chest computed tomography (CT) for preoperative staging in CRC. METHODS: From January 2006 to December 2007, a total of 597 patients with colorectal cancer underwent surgery at our hospital. One hundred fifty of those patients had received chest CT preoperatively. We analyzed the chest radiologic findings from chest x-ray (CXR), abdominal CT, and chest CT. RESULTS: The detection rate of abnormal lung findings was higher in chest CT than in the other chest radiologic findings (chest PA: 10 [6.6%]; abdominal CT: 19 [12.7%]; chest CT: 48 [32.0%]). On the chest CT, 19 of the 150 (12.7%) patients that had received a chest CT preoperatively were initially suspected of having malignant lesions. Besides two primary lung malignancies (solitary nodules), metastatic lesions were revealed in 5 (3.3%), 11 (7.3%), and 17 (11.3%) patients on CXR, abdominal CT, and chest CT, respectively. Eleven (64.7%) of the patients having metastatic chest CT lesions were also identified on lower lung fields by abdominal CT. Seven also had other metastatic foci (liver and paraaortic LN). Initially, stage IV was identified in 37 (24.7%) and 40 (26.7%) patients in abdominal CT and chest CT, respectively. After one year, 11 of the 150 (7.3%) patients who had received a chest CT had been diagnosed with pulmonary metastasis. CONCLUSION: Chest computed tomography is the most sensitive method for the diagnosis of pulmonary metastases. However, if the interpretations of abdominal CT and individualized diagnostic methods are accurate, the demand for unnecessary preoperative work-up may be reduced.

Colonoscopic ultrasound is associated with a learning phenomenon despite previous rigid probe experience.

Colonoscopic ultrasound (CUS) enables total colonoscopic examination combined with staging of tumor. Rigid probe transrectal ultrasound (TRUS) is reliable in assessing rectal cancer. Both the modalities are associated with an initial learning curve. We evaluated the predictability CUS in preoperative staging of rectal cancer during the learning curve, despite experience with TRUS. Forty-four patients with non-obstructing rectal cancer were assessed by colonoscopy and colonic ultrasound using a 7.5 MHz rotating transducer. Accuracy of ultrasound staging was compared with pathological staging. Tumor staging and nodal staging at pathology and ultrasound were named pT, pN and uT, uN, respectively. The pathological staging was pT1 in two (4.5%), pT2 in 16 (36%), pT3 in 21 (48%) and pT4 in five (11.5%) rectal cancer specimens. CUS understaged the tumor in 11 cases and overstaged it in 10 cases. Overall, the positive predictive value was 61%, negative predictive value 73%, sensitivity 61%, and specificity 73%. Lymph nodes were not visualized in 14. The overall un-weighted kappa of CUS staging of RC was 0.18 (poor). The predictive value in tumor staging of CUS is suboptimal in the learning phase, despite previous experience with TRUS.

Utilidad del ultrasonido transrectal sin balón en la estadificación preoperatoria del cáncer rectal / Usefulness of the endorectal ultrasound without ballon in preoperative staging of rectal cancer

Objective: To determine the usefulness of Endorectal Ultrasound (ERUS) without balloon in preo-perative staging of malignant rectal tumors. Method: From July 2003 to July 2007 a study was performed in 57 patients diagnosed with cancer of the rectum, who underwent preoperative staging by transrectal ultrasonography to be subsequently compared with an anatomopathologic analysis of the surgical sample. Results: US staging according to degrees of invasion (T-stage) was coincident in 87,7 percent with the anatomopathologic staging. Sensitivity and specificity values were 0,80 and 0,92 percent respectively for UT2,while 0,94 and 0,81 percent, respectively, for UT3. According to regional lymph nodes spread (N-stage), it exhibited a coincidence of 78,9 percent; sensitivity was 0,82 percent and specificity was 0,74 per cent for UNO; while sensitivity and specificity reached values of 0,74 and 0,82 percent, respectively, for UN1. Conclusion: Endorectal US without balloon has proved to be useful in the preoperative staging of malignant rectal tumors.

Objetivos: Determinar la utilidad del ultrasonido transrectal sin balón (USTRsb) en la estadificación preoperatoria del cáncer rectal. Método: Estudiamos 57 pacientes con diagnóstico de cáncer rectal desde julio 2003 a Julio 2007, a los que se les realizó estadificación preoperatoria por ultrasonido transrectal y anatomopatológico por medio del examen de la pieza quirúrgica. Resultados: La estadificación ultrasonográfica según grado de invasión tumoral coincidió con la anatomopatológica en el 87,7 por ciento ; la sensibilidad y especificidad fue 0,80 y 0,92 para los UT2 y 0,94 y 0,81 para los UT3. Según la invasión de ganglios linfáticos regionales, la coincidencia fue 78,9 por ciento ; la sensibilidad y especificidad fue 0,82 y 0,74 para los UNO y 0,74 y 0,82para los UN1. Conclusión: El USTRsb fue útil en la estadificación preoperatoria del cáncer rectal.

The Usefulness of Transrectal Ultrasonography for Preoperatively Staging Rectal Cancer

PURPOSE: The preoperative assessments of the depth of invasion in the rectal wall and the presence of lymph node metastasis are very important in determining the proper treatment modality for rectal cancer. The purpose of this study is to evaluate the accuracy of transrectal ultrasonography (TRUS) for preoperatively staging rectal cancer, as compared with computerized tomography (CT). METHODS: 62 patients who were diagnosed with rectal cancer were staged by using TRUS and CT, preoperatively. The ultrasnonographic tumor stage (uT), the US nodal stage (uN) and the computerized tomographic tumor stage (cT) and the CT nodal (cN) stage were investigated. The accuracy, sensitivity, specificity, PPV (Positive predictive value) and NPV (Negative predictive value) were calculated and compared with the pathologic staging. RESULTS: The accuracies of TRUS and CT in assessing the depth of rectal wall invasion were 82.2% and 79.0%, respectively. The sensitivity, specificity, PPV and NPV of TRUS were 68.1%, 81.9%, 70.4% and 85.4% and those of CT were 53.2%, 78.9%, 73.7% and 80.7%, respectively. The sensitivity of T1 was 77.8% with using TRUS and 33.3% with using CT, respectively. The incidence of over- and under-staging was 17.8% and 9.7% with using TRUS and 25.8% and 6.5% with using CT, respectively. The accuracies of TRUS and CT in assessing the involvement of lymph nodes were 62.4% and 68.8%, respectively. The incidence of over-staging for TRUS and CT was 41.9% and 21.0%, respectively. The incidence of under-staging for TRUS and CT was 20.1% and 25.8%, respectively. There was no meaningful factor influencing the accuracy of TRUS. CONCLUSION: TRUS is very useful tool for the preoperative assessment of the depth of rectal cancer invasion. However, the evaluation of lymph node involvement by TRUS has limitations.

Application of ultrasonic miniature probe in preoperative staging of colorectal carcinoma / 上海第二医科大学学报

Objective To evaluate the diagnostic accuracy of ultrasound miniature probe(UMP)examination in tumor invasion(T staging) and local lymphatic node metastasis(N staging) for colorectal carcinoma. Methods Preoperative UMP examinations(12 MHz) were performed on 53 patients with colorectal carcinoma undergoing surgeries.The diagnosis accuracy of UMP examination in T and N staging was determined by comparison of the results of operation exploration and histopathologic findings. Results The accuracy in T staging for colorectal carcinoma was 86% with UMP examination,and that for early stage colorectal carcinoma was 100%.The accuracy,sensitivity and specificity in N staging for colorectal carcinoma were 81%,77%,and 84%,respectively with UMP examination. Conclusion UMP examination works well in determining T stage of colorectal carcinoma,especially for early stage colorectal carcinoma and those with tumor stenosis.

Recent Progress in Diagnosis and Treatment of Rectal Cancer / 대한소화기학회지

Rectal cancer is an emerging health issue in Korea because its incidence is rapidly increasing with changes in life styles and diets. The optimal treatment of rectal cancer is based on multimodality. Among them, surgical treatment is the corner-stone. In the past, local recurrence rate has been reported as high as 30-40%, but the concept of total mesorectal excision (TME) lowered the rate of local recurrence down to less than 10%. TME focuses on sharp pelvic dissection and complete removal of rectal cancer with surrounding mesorectum inside the rectal proper fascia. TME is now considered as a standard procedure for surgical treatment of mid and low rectal cancer. With the introduction of pelvic magnetic resonance imaging (MRI) for preoperative staging of rectal cancer, risk factors for local recurrence can be predicted before surgery to distinguish patients who are in high risk for recurrence that requires preoperative neoadjuvant chemoradiation therapy. Early rectal cancer was assessed by transrectal ultrasonography (TRUS) and endorectal MRI with coil. Transanal local excision can be applied with anal sphincter preservation safely. Neoadjuvant chemoradiation therapy was performed in patients with locally advanced rectal cancer, and this resulted in tumor size reductions and histopathologic downstaging effect. As far as the quality of life is concerned, sexual and voiding function are much improved by techniques preserving nerve. Many experts have dealt with challenging practical problems of managing rectal cancer from diagnosis to quality of life. This issue contains recent progresses in the diagnosis and treatment of rectal cancer which will serve as a comprehensive reference for those who manage rectal cancer in their medical practice.

Research Progress of Preoperative Staging Diagnosis of Gastric Cancer / 中国普外基础与临床杂志

Objective To summarize the research progress of preoperative staging diagnosis for gastric cancer.Methods Both the domestic and international literatures involving the preoperative staging diagnosis of gastric cancer in recent years were collected and reviewed.Results Transabdominal ultrosonography,EUS,CT,MRI,PET and diagnostic laparoscopy could provide objective evidences,and enhanced the accuracy of preoperative staging diagnosis for gastric cancer.Conclusion With the development of examination methods,the assessment of preoperative staging diagnosis of gastric cancer has been improved,and operation strategy can be made according to the correct preoperative staging.

Preoperative Staging of Rectal Cancer by CT & MRI

Accurate staging of rectal cancer preoperatively is important to plan a proper treatment and to predict treatment results. For the preoperative staging of rectal cancer, computed tomography (CT), transrectal ultrasonography (TRUS), and magnetic resonance imaging (MRI) have been used, but the role of them remains controversial. This research was intended to compare and analyze the accuracy of CT and MRI in the preoperative staging of rectal cancer. METHODS: From January 1998 to June 1999, sixty patients were studied by CT and MRI before their operations for rectal cancer in our institution, but two patients with local excision were excluded in N-staging as objects. The patients who had preoperative irradiation were also excluded in this study. Preoperative staging with CT and MRI were conducted by one radiologist according to 1997's TNM classification based on AJCC. On the results of pathological findings after operation, preoperative staging with CT and MRI were classified into T-staging and N-staging. Accuracy and agreement rate between pathological staging and preoperative staging by CT and MRI were compared and analyzed by Kappa value. RESULTS: The accuracy of CT was 68 percent in T-staging, and 58 percent in N-staging, MRI showed accuracy of 82 percent in T-staging and 64 percent in N-staging. In the T-staging, the agreement rate between pathological staging and CT staging was 0.54 (95% confidence interval), while the agreement rate was 0.70 in MRI staging, resulting in a higher agreement rate with MRI than with CT. In the N-staging, the agreement rate between pathological staging and CT staging was 0.38, with a relatively lower agreement rate, while the agreement rate was 0.56 in MRI staging. In our study, MRI showed a higher agreement rate than CT. CONCLUSIONS: In the future, more research should be conducted, but it can be conclued that in preoperative staging for rectal cancer, MRI using body arrayed coil has a better accuracy than CT. Subsequently MRI staging should be considered as a more useful investigation method before operation than CT.