Diagnostic accuracy of endoscopic ultrasound, computed tomography, magnetic resonance imaging, and endorectal ultrasonography for detecting lymph node involvement in patients with rectal cancer

Wang, Xin; Gao, Ya; Ji-pin, LI; Wu, Jiarui; Wang, Bo; Ma, Xueni; Shen, Minghui; Wang, Jiancheng

doi:10.1097/md.0000000000012899

Cited by 12 publications

(11 citation statements)

References 38 publications

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“…The histological classification used in this study was depended on the WHO 2019 classification. A challenge in the identification of nodes with EUS is the inability to visualize nodes that are outside the range of the transducer [ 18 – 20 ]. Thus, gastric cancer N staging remains an area of uncertainty.…”

Section: Methodsmentioning

confidence: 99%

The New American Joint Committee on Cancer T staging system for stomach: increased complexity without clear improvement in predictive accuracy for endoscopic ultrasound

Han

Zhang

et al. 2021

BMC Gastroenterol

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Background The efficacy of endoscopic ultrasound (EUS) for determining the T category of gastric cancer is variable. The aim of this study was to evaluate the superiority of EUS by using the 6th edition American Joint Committee on Cancer (AJCC) staging system for stomach cancer compared to the new 7th/8th edition. Methods A retrospective analysis of clinical and EUS imaging features of 348 gastric carcinoma patients who underwent radical resection were retrospectively analyzed. Differences between the 6th and 7th/8th edition T staging systems for preoperative EUS evaluation were compared. Results The accuracy of EUS T staging was 72.4% for the 7th/8th edition and 78.4% for the 6th edition. T3 stage accuracy was significantly worse when the T3 group status was changed. The tumor location, echoendoscope type, and histological type were associated with inaccuracy. We further analyzed the EUS image features for each tumor T stage and found that an indistinctly visible muscularis propria (MP) or with obvious thickening was considered an indicator of lesions involved in the MP with a sensitivity of 81.3%; an MP completely disappeared and accompanied with a serosal layer intact may be a marker that the lesion invaded to the subserosa. We also found that irregularities in the outer edge of the gastric wall were markers of gastric serosal layer penetration with a positive predictive value of 92.2%. Conclusions The increased complexity of the 7th/8th edition T staging system is accompanied by worsening of the predictive accuracy for EUS as compared to the 6th edition. Furthermore, the tumor location, echoendoscope type, histological type, and EUS image features for each tumor T stage should warrant attention.

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Section: Methodsmentioning

confidence: 99%

The New American Joint Committee on Cancer T staging system for stomach: increased complexity without clear improvement in predictive accuracy for endoscopic ultrasound

Han

Zhang

et al. 2021

BMC Gastroenterol

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“…Challenge in the identification of nodes with EUS is the inability to visualize nodes that are outside the range of the transducer [16][17][18]. Thus, gastric cancer N staging remains to be an area of uncertainty.…”

Section: Data Collectionmentioning

confidence: 99%

The New American Joint Committee on Cancer T Staging System for Stomach: Increased Complexity without Clear Improvement in Predictive Accuracy for Endoscopic Ultrasound

Han

Tao

Zhang

et al. 2020

Preprint

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Background: The efficacy of endoscopic ultrasound (EUS) for determining T category is variable for gastric cancer. The aim of this study is to evaluate the superiority of EUS by using the 6th edition American Joint Committee on Cancer (AJCC) staging system for stomach cancer compared to the new 7th/8th edition.Methods: A retrospective analysis of clinical and EUS imaging features of 348 gastric carcinoma patients who underwent radical resection were collected. Differences between the 6th edition and 7th/8th edition T staging system for EUS preoperative evaluated were compared.Results: The accuracy of EUS T staging was 72.4% for 7th/8th edition and 78.4% for 6th edition; especially the T3 stage accuracy was significantly worse when T3 group status was changed. The tumor location, EUS type and histological type were associated with inaccuracy. We further analyzed the EUS image features for each tumor T stage and found muscularis propria (MP) visible indistinctly or obvious thickening were considered to be indicators that lesions involved to the MP with a sensitivity of 81.3%; MP disappeared completely and accompanied with serosal layer intact might be a marker that lesion invaded to the subserosa; We also found that irregularities in the outer edge of the gastric wall were markers of gastric serosal layer penetration with a positive predictive value of 92.2%.Conclusions: The increased complexity of the 7th/8th edition T staging system is accompanied by worsening in the predictive accuracy for EUS as compared to the 6th edition. Furthermore, the tumor location, EUS type, histological type and EUS image features for each tumor T stage should warrant attention.

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“…Risk factors for rectal cancer include Familial Polyposis Syndrome, Diabetes Mellitus, Obesity, Alcohol and Smoking. 1 The most accurate imaging technique to evaluate Positive Circumferential Resection Margin (pCRM) status before Total Mesorectal Excision (TME) is high resolution Magnetic Resonance Imaging (MRI); however, after long course Chemoradiotherapy (CRT) the accuracy of MRI decreases in determining pCRM involvement. Previously some studies showed moderate accuracy of 64-92% in predicting Mesorectal Fascia (MRF) invasion and 33-45% in predicting CRM involvement with post CRT MRI.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of MRI in mesorectal fascial involvement

Saeed¹,

Muhammad²,

Akhtar

et al. 2022

J REHMAN MED INST

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Introduction: Evaluation of mesorectal fascial involvement in rectal cancer is of prime importance in decision making regarding treatment options. Objective: To determine diagnostic accuracy of Magnetic Resonance Imaging (MRI) in detection of mesorectal fascia involvement in rectal carcinoma patients using histopathology as gold standard. Materials & Methods: A comparative study was performed in the Radiology department of Kuwait Teaching Hospital, Peshawar, from January 1, 2021, till December 31, 2021, on 155 patients of rectal carcinoma who had their MRI done for rectal cancer on 0.3T MR Machine. Surgical findings like mesorectal fascial involvement by the tumor, presence/absence of pelvic lymph nodes within 5mm of mesorectal fascia, and staging of the tumor were included as variables. Specimens were sent in formalin to a histopathologist, and findings were considered for comparison. Data were analyzed using SPSS version 23. Results: Out of 155 patients, 82 patients showed mesorectal fascial involvement whereas 73 patients were Circumferential Resection Margin (CRM) negative. Out of these 7 patients were falsely labeled as CRM positive on MRI, whereas 9 patients were falsely labeled as CRM negative on MRI. Positive predictive value was 91%, with negative predictive value of 88%. Diagnostic accuracy was 89.6%. Sensitivity was 89% whereas specificity was 90.4%. Conclusion: MRI has high sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for detection of mesorectal fascial involvement in case of rectal carcinoma taking 5mm as cut off value.

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Diagnostic accuracy of endoscopic ultrasound, computed tomography, magnetic resonance imaging, and endorectal ultrasonography for detecting lymph node involvement in patients with rectal cancer

Cited by 12 publications

References 38 publications

The New American Joint Committee on Cancer T staging system for stomach: increased complexity without clear improvement in predictive accuracy for endoscopic ultrasound

The New American Joint Committee on Cancer T staging system for stomach: increased complexity without clear improvement in predictive accuracy for endoscopic ultrasound

The New American Joint Committee on Cancer T Staging System for Stomach: Increased Complexity without Clear Improvement in Predictive Accuracy for Endoscopic Ultrasound

Diagnostic accuracy of MRI in mesorectal fascial involvement

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