Comparison of CT & MRI Findings in the Staging of Rectosigmoid Carcinoma According to New AJCC Classification

ABSTRACT

PURPOSE: To evaluate the diagnostic accuracy of computed tomography(CT) and magnetic resonance imaging(MRI)in the staging of rectosigmoid carcinoma according to the new AJCC classification. MATERIALS AND METHODS: BetweenAugust 1997 and October 1998, 36 patients with pathologically proven rectosigmoid carcinoma who underwent preoperative CT and MRI were evaluated. CT scans were performed with spiral CT in 27 cases and with conventional CT in nine. In all cases, MR images were obtained using a 1.5T unit and a body arrayed coil. T1- and T2-weightedimages were obtained in axial, sagittal, and coronal planes. On the basis of the results of CT scanning and MRI,tumor stage was determined by two radiologists using the AJCC cancer staging manual(1997). They reached aconsensus and compared their results with the pathologic stage. The T-stage was T1 in three cases, T2 in two, T3in 26, and T4 in five. The N-stage was N0 in 16 cases, N1 in seven, and N2 in 13. RESULTS: In the case of CT, thediagnostic accuracy of T-staging was 67%, and that of N-staging, 44%. For MRI, the corresponding figures were 83%and 67%. For T-staging, MRI was more accurate than CT(P=0.006), but for N-staging, the diagnostic accuracy of CT and MRI was statistically equivalent (P>0.05). CONCLUSION: MRI using a body arrayed coil is a useful preoperative diagnostic tool for the local staging of rectosigmoid carcinoma.