Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence

Waleed Abdelfattah Mousa; Tarek Fawzy Abdella

doi:doi:10.11648/j.ijmi.20170502.13

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Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence

Waleed Abdelfattah Mousa, Tarek Fawzy Abdella

Published in International Journal of Medical Imaging (Volume 5, Issue 2)

Received: 19 December 2016 Accepted: 3 January 2017 Published: 25 March 2017

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Abstract

Objective: MRI is currently the imaging modality of choice for the detection, characterization, and staging of rectal cancer. A variety of examinations have been used for preoperative staging of rectal cancer, including digital rectal examination, endorectal (endoscopic) ultrasound, CT, and MRI. Endoscopic ultrasound is the imaging modality of choice for small and small superficial tumors. MRI is superior to CT for assessing invasion to adjacent organs and structures, especially low tumors that carry a high risk of recurrence. Background: Colorectal cancer (CRC) is the third most common cancer in both sexes combined worldwide, after prostate and breast cancer with an incidence of 40 in 100,000. Rectal carcinoma accounts for more than one-third of colorectal tumors and is associated with signiﬁcant morbidity and mortality. Currently, MRI using diffusion weighted sequence is the most sensitive and specific modality in staging rectal cancer as it is able to depict the mesorectal fascia and its relation to the tumor margins precisely. Methods: This study included 50 patients, (32 male and 18 female) previously diagnosed as cancer rectum based on proctoscope and histopathological biopsy. The age range of the patients was from 18 years to 78 years. All patients will be subjected to the following: detailed history, clinical examination, proctoscopic assessment and histopathological data. All patients underwent MRI of the pelvis specifically cancer rectum protocol. Results: The most frequently encountered clinical presentation among cancer rectum patients was bleeding per rectum (14), constipation (26), incidentally discovered liver metastasis (6) and intestinal obstruction (4). MRI evaluation of T staging in correlation to the histopathological examination showed sensitivity (80%), specificity (93%), accuracy (94%). Lymph node (LN) metastatic spread was evaluated by MRI and showed sensitivity (87%), specificity (92%), accuracy (92.6%), PPV (84.8%) and NPV (96.7%). Regarding circumferential resection margin (CRM) MRI assessment revealed; sensitivity (96%), specificity (94%), accuracy (96%), PPV (95%) and NPV (94.3%). Conclusions: MRI is an accurate and sensitive imaging method delineating tumoral margins, mesorectal fascia involvement, lymph nodes, and distant metastasis. MRI can accurately delineate the mesorectal fascia involvement, which is one of the main decision points in planning treatment.

Published in	International Journal of Medical Imaging (Volume 5, Issue 2)
DOI	10.11648/j.ijmi.20170502.13
Page(s)	19-25
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Magnetic Resonance Imaging, Diffusion, Cancer Rectum, Tumor Staging

References

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[3]	D. M. Ganeshan, et al. MRI Evaluation of Rectal Carcinoma, Cross-Sectional Imaging of the Abdomen and Pelvis: A Practical Algorithmic Approach, New York: Springer, 2015: 417-433.
[4]	Klessen, C., Rogalla, P., & Taupitz, M. Local staging of rectal cancer: the current role of MRI. European radiology 2007; 2: 379-389.
[5]	Ümit Tapan, Mustafa Özbayrak, Servet Tatlı. MRI in local staging of rectal cancer: an update. Diagnostic Interventional Radiology 2014; 20: 390-398.
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[18]	Zhang XM, Zhang HL, et al. 3-T MRI of rectal carcinoma: preoperative diagnosis, staging and planning of sphincter-sparing surgery. AJR Am J Roentgenol 2008; 5: 1271–8.
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Waleed Abdelfattah Mousa, Tarek Fawzy Abdella. (2017). Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence. International Journal of Medical Imaging, 5(2), 19-25. https://doi.org/10.11648/j.ijmi.20170502.13

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Waleed Abdelfattah Mousa; Tarek Fawzy Abdella. Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence. Int. J. Med. Imaging 2017, 5(2), 19-25. doi: 10.11648/j.ijmi.20170502.13

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AMA Style

Waleed Abdelfattah Mousa, Tarek Fawzy Abdella. Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence. Int J Med Imaging. 2017;5(2):19-25. doi: 10.11648/j.ijmi.20170502.13

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@article{10.11648/j.ijmi.20170502.13,
  author = {Waleed Abdelfattah Mousa and Tarek Fawzy Abdella},
  title = {Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence},
  journal = {International Journal of Medical Imaging},
  volume = {5},
  number = {2},
  pages = {19-25},
  doi = {10.11648/j.ijmi.20170502.13},
  url = {https://doi.org/10.11648/j.ijmi.20170502.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20170502.13},
  abstract = {Objective: MRI is currently the imaging modality of choice for the detection, characterization, and staging of rectal cancer. A variety of examinations have been used for preoperative staging of rectal cancer, including digital rectal examination, endorectal (endoscopic) ultrasound, CT, and MRI. Endoscopic ultrasound is the imaging modality of choice for small and small superficial tumors. MRI is superior to CT for assessing invasion to adjacent organs and structures, especially low tumors that carry a high risk of recurrence. Background: Colorectal cancer (CRC) is the third most common cancer in both sexes combined worldwide, after prostate and breast cancer with an incidence of 40 in 100,000. Rectal carcinoma accounts for more than one-third of colorectal tumors and is associated with signiﬁcant morbidity and mortality. Currently, MRI using diffusion weighted sequence is the most sensitive and specific modality in staging rectal cancer as it is able to depict the mesorectal fascia and its relation to the tumor margins precisely. Methods: This study included 50 patients, (32 male and 18 female) previously diagnosed as cancer rectum based on proctoscope and histopathological biopsy. The age range of the patients was from 18 years to 78 years. All patients will be subjected to the following: detailed history, clinical examination, proctoscopic assessment and histopathological data. All patients underwent MRI of the pelvis specifically cancer rectum protocol. Results: The most frequently encountered clinical presentation among cancer rectum patients was bleeding per rectum (14), constipation (26), incidentally discovered liver metastasis (6) and intestinal obstruction (4). MRI evaluation of T staging in correlation to the histopathological examination showed sensitivity (80%), specificity (93%), accuracy (94%). Lymph node (LN) metastatic spread was evaluated by MRI and showed sensitivity (87%), specificity (92%), accuracy (92.6%), PPV (84.8%) and NPV (96.7%). Regarding circumferential resection margin (CRM) MRI assessment revealed; sensitivity (96%), specificity (94%), accuracy (96%), PPV (95%) and NPV (94.3%). Conclusions: MRI is an accurate and sensitive imaging method delineating tumoral margins, mesorectal fascia involvement, lymph nodes, and distant metastasis. MRI can accurately delineate the mesorectal fascia involvement, which is one of the main decision points in planning treatment.},
 year = {2017}
}

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TY  - JOUR
T1  - Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence
AU  - Waleed Abdelfattah Mousa
AU  - Tarek Fawzy Abdella
Y1  - 2017/03/25
PY  - 2017
N1  - https://doi.org/10.11648/j.ijmi.20170502.13
DO  - 10.11648/j.ijmi.20170502.13
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 19
EP  - 25
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20170502.13
AB  - Objective: MRI is currently the imaging modality of choice for the detection, characterization, and staging of rectal cancer. A variety of examinations have been used for preoperative staging of rectal cancer, including digital rectal examination, endorectal (endoscopic) ultrasound, CT, and MRI. Endoscopic ultrasound is the imaging modality of choice for small and small superficial tumors. MRI is superior to CT for assessing invasion to adjacent organs and structures, especially low tumors that carry a high risk of recurrence. Background: Colorectal cancer (CRC) is the third most common cancer in both sexes combined worldwide, after prostate and breast cancer with an incidence of 40 in 100,000. Rectal carcinoma accounts for more than one-third of colorectal tumors and is associated with signiﬁcant morbidity and mortality. Currently, MRI using diffusion weighted sequence is the most sensitive and specific modality in staging rectal cancer as it is able to depict the mesorectal fascia and its relation to the tumor margins precisely. Methods: This study included 50 patients, (32 male and 18 female) previously diagnosed as cancer rectum based on proctoscope and histopathological biopsy. The age range of the patients was from 18 years to 78 years. All patients will be subjected to the following: detailed history, clinical examination, proctoscopic assessment and histopathological data. All patients underwent MRI of the pelvis specifically cancer rectum protocol. Results: The most frequently encountered clinical presentation among cancer rectum patients was bleeding per rectum (14), constipation (26), incidentally discovered liver metastasis (6) and intestinal obstruction (4). MRI evaluation of T staging in correlation to the histopathological examination showed sensitivity (80%), specificity (93%), accuracy (94%). Lymph node (LN) metastatic spread was evaluated by MRI and showed sensitivity (87%), specificity (92%), accuracy (92.6%), PPV (84.8%) and NPV (96.7%). Regarding circumferential resection margin (CRM) MRI assessment revealed; sensitivity (96%), specificity (94%), accuracy (96%), PPV (95%) and NPV (94.3%). Conclusions: MRI is an accurate and sensitive imaging method delineating tumoral margins, mesorectal fascia involvement, lymph nodes, and distant metastasis. MRI can accurately delineate the mesorectal fascia involvement, which is one of the main decision points in planning treatment.
VL  - 5
IS  - 2
ER  -

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Author Information

Waleed Abdelfattah Mousa

Department of Diagnostic Radiology, Menoufia University, Menoufia, Egypt
Tarek Fawzy Abdella

Department of Diagnostic Radiology, Menoufia University, Menoufia, Egypt

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Plain Text BibTeX RIS

APA Style

Waleed Abdelfattah Mousa, Tarek Fawzy Abdella. (2017). Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence. International Journal of Medical Imaging, 5(2), 19-25. https://doi.org/10.11648/j.ijmi.20170502.13

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ACS Style

Waleed Abdelfattah Mousa; Tarek Fawzy Abdella. Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence. Int. J. Med. Imaging 2017, 5(2), 19-25. doi: 10.11648/j.ijmi.20170502.13

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AMA Style

Waleed Abdelfattah Mousa, Tarek Fawzy Abdella. Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence. Int J Med Imaging. 2017;5(2):19-25. doi: 10.11648/j.ijmi.20170502.13

Copy | Download

@article{10.11648/j.ijmi.20170502.13,
  author = {Waleed Abdelfattah Mousa and Tarek Fawzy Abdella},
  title = {Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence},
  journal = {International Journal of Medical Imaging},
  volume = {5},
  number = {2},
  pages = {19-25},
  doi = {10.11648/j.ijmi.20170502.13},
  url = {https://doi.org/10.11648/j.ijmi.20170502.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20170502.13},
  abstract = {Objective: MRI is currently the imaging modality of choice for the detection, characterization, and staging of rectal cancer. A variety of examinations have been used for preoperative staging of rectal cancer, including digital rectal examination, endorectal (endoscopic) ultrasound, CT, and MRI. Endoscopic ultrasound is the imaging modality of choice for small and small superficial tumors. MRI is superior to CT for assessing invasion to adjacent organs and structures, especially low tumors that carry a high risk of recurrence. Background: Colorectal cancer (CRC) is the third most common cancer in both sexes combined worldwide, after prostate and breast cancer with an incidence of 40 in 100,000. Rectal carcinoma accounts for more than one-third of colorectal tumors and is associated with signiﬁcant morbidity and mortality. Currently, MRI using diffusion weighted sequence is the most sensitive and specific modality in staging rectal cancer as it is able to depict the mesorectal fascia and its relation to the tumor margins precisely. Methods: This study included 50 patients, (32 male and 18 female) previously diagnosed as cancer rectum based on proctoscope and histopathological biopsy. The age range of the patients was from 18 years to 78 years. All patients will be subjected to the following: detailed history, clinical examination, proctoscopic assessment and histopathological data. All patients underwent MRI of the pelvis specifically cancer rectum protocol. Results: The most frequently encountered clinical presentation among cancer rectum patients was bleeding per rectum (14), constipation (26), incidentally discovered liver metastasis (6) and intestinal obstruction (4). MRI evaluation of T staging in correlation to the histopathological examination showed sensitivity (80%), specificity (93%), accuracy (94%). Lymph node (LN) metastatic spread was evaluated by MRI and showed sensitivity (87%), specificity (92%), accuracy (92.6%), PPV (84.8%) and NPV (96.7%). Regarding circumferential resection margin (CRM) MRI assessment revealed; sensitivity (96%), specificity (94%), accuracy (96%), PPV (95%) and NPV (94.3%). Conclusions: MRI is an accurate and sensitive imaging method delineating tumoral margins, mesorectal fascia involvement, lymph nodes, and distant metastasis. MRI can accurately delineate the mesorectal fascia involvement, which is one of the main decision points in planning treatment.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Rectal Carcinoma, Recent Staging Strategy by MRI Using Diffusion Weighted Sequence
AU  - Waleed Abdelfattah Mousa
AU  - Tarek Fawzy Abdella
Y1  - 2017/03/25
PY  - 2017
N1  - https://doi.org/10.11648/j.ijmi.20170502.13
DO  - 10.11648/j.ijmi.20170502.13
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 19
EP  - 25
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20170502.13
AB  - Objective: MRI is currently the imaging modality of choice for the detection, characterization, and staging of rectal cancer. A variety of examinations have been used for preoperative staging of rectal cancer, including digital rectal examination, endorectal (endoscopic) ultrasound, CT, and MRI. Endoscopic ultrasound is the imaging modality of choice for small and small superficial tumors. MRI is superior to CT for assessing invasion to adjacent organs and structures, especially low tumors that carry a high risk of recurrence. Background: Colorectal cancer (CRC) is the third most common cancer in both sexes combined worldwide, after prostate and breast cancer with an incidence of 40 in 100,000. Rectal carcinoma accounts for more than one-third of colorectal tumors and is associated with signiﬁcant morbidity and mortality. Currently, MRI using diffusion weighted sequence is the most sensitive and specific modality in staging rectal cancer as it is able to depict the mesorectal fascia and its relation to the tumor margins precisely. Methods: This study included 50 patients, (32 male and 18 female) previously diagnosed as cancer rectum based on proctoscope and histopathological biopsy. The age range of the patients was from 18 years to 78 years. All patients will be subjected to the following: detailed history, clinical examination, proctoscopic assessment and histopathological data. All patients underwent MRI of the pelvis specifically cancer rectum protocol. Results: The most frequently encountered clinical presentation among cancer rectum patients was bleeding per rectum (14), constipation (26), incidentally discovered liver metastasis (6) and intestinal obstruction (4). MRI evaluation of T staging in correlation to the histopathological examination showed sensitivity (80%), specificity (93%), accuracy (94%). Lymph node (LN) metastatic spread was evaluated by MRI and showed sensitivity (87%), specificity (92%), accuracy (92.6%), PPV (84.8%) and NPV (96.7%). Regarding circumferential resection margin (CRM) MRI assessment revealed; sensitivity (96%), specificity (94%), accuracy (96%), PPV (95%) and NPV (94.3%). Conclusions: MRI is an accurate and sensitive imaging method delineating tumoral margins, mesorectal fascia involvement, lymph nodes, and distant metastasis. MRI can accurately delineate the mesorectal fascia involvement, which is one of the main decision points in planning treatment.
VL  - 5
IS  - 2
ER  -

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