Staging of colorectal cancer using contrast-enhanced multidetector computed tomographic colonography
Singapore medical journal
; : 660-666, 2014.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-244767
Responsible library:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>Preoperative staging is essential for the optimal treatment and surgical planning of colorectal cancers. This study was aimed to evaluate the accuracy of colorectal cancer staging done using contrast-enhanced multidetector computed tomographic colonography (CEMDCTC).</p><p><b>METHODS</b>We recruited 25 patients with 28 proven colorectal cancers. A 16-slice multidetector computed tomography scanner was used to generate two-dimensional multiplanar reformatted sagittal, coronal and oblique coronal images, and three-dimensional virtual colonography (endoluminal) images. Axial and reformatted views were analysed, and TNM staging was done. Patients underwent surgery and conventional colonoscopy, and surgical histopathological correlation was obtained.</p><p><b>RESULTS</b>The diagnostic accuracies for TNM colorectal cancer staging were 92.3% for T staging, 42.3% for N staging and 96.1% for M staging using CEMDCTC. There was excellent positive correlation for T staging between CEMDCTC and both surgery (κ-value = 0.686) and histopathology (κ-value = 0.838) (p < 0.0001), and moderate positive correlation for N staging between CEMDCTC and surgery (κ-value = 0.424; p < 0.0001). The correlation between CEMDCTC and histopathology for N staging was poor (κ-value = 0.186; p < 0.05); the negative predictive value was 100% for lymph node detection. Moderate positive correlation was seen for M staging between CEMDCTC and both surgery (κ-value = 0.462) and histopathology (κ-value = 0.649). No false negatives were identified in any of the M0 cases.</p><p><b>CONCLUSION</b>CEMDCTC correlated well with pathologic T and M stages, but poorly with pathologic N stage. It is an extremely accurate tool for T staging, but cannot reliably distinguish between malignant lymph nodes and enlarged reactive lymph nodes.</p>
Full text:
Available
Database:
WPRIM (Western Pacific)
Main subject:
Pathology
/
Reference Standards
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General Surgery
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Colorectal Neoplasms
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Prospective Studies
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Reproducibility of Results
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Contrast Media
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Colonography, Computed Tomographic
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Diagnosis
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Multidetector Computed Tomography
Type of study:
Diagnostic study
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Observational study
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Prognostic study
Limits:
Adolescent
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Adult
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Aged
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Aged, 80 and over
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Female
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Humans
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Male
Language:
English
Journal:
Singapore medical journal
Year:
2014
Document type:
Article