Endorectal ultrasound: instrumentation and clinical aspects

Abstract

During the period 1983 to April 1986, 129 patients with rectal cancer were treated. In 76 of these depth of penetration of the rectal wall by tumour was assessed by ultrasound. T stage determined by ultrasound (uT) corresponded with the pathological stages (pT) in 67 patients. In the remaining 9 cases, ultrasound overstaged the tumour and in only one patient was the growth understaged. Lymph nodes could be visualised in 12 out of 27 patients in whom nodes were looked for but only six cases were found to be positive on histological examination. Of 22 recurrences detected or proven by ultrasound there was a group of 6 patients who had no other sign of recurrence.

Limits of Endorectal Ultrasound in Tailoring Treatment of Patients with Rectal Cancer

“…In this group, 70 (97%) out of 72 who were candidates for local excision would have been correctly treated, as we have already reported in a previous study with early cancers treated with local excision [21]. However, recalling what others have also documented [17,22,23,24], in our own experience staging T2 tumors was particularly challenging. As a direct consequence, allocation of patients to direct surgery (group of indication 2) was or would have been wrong in more than half of the cases.…”

Endosonographic staging of rectal carcinoma

“…Better results, however, are obtained by transrectal US using radial or linear high-resolution probes [16][17][18][19][20][21][22][23][24][25][26][27]. Endosonography is in effect the imaging method that shows the layers inside the rectal wall.…”

“…Thus, it becomes difficult to determine the degree of tumor extension in or through the muscular wall, especially in the case of small tumors and slight infiltration. The demarcation line can be detected by endosonographic scans using linear or radial high-resolution probes (5-7.5 MHz) and is represented by the hypoechogenic layer of the muscularis propria [16][17][18][19][20][21][22][23][24][25][26][27].…”

Preoperative Staging: A Critical Analysis

“…1). The physical and anatomical description of the two hypoechoic and three hyperechoic layers is extensively discussed elsewhere [9,31,33]. The uT-staging definition of 1985 was later accepted by Saitoh and associates [50], Yamashita and coworkers [59] and many others.…”

“…Hildebrandt and Feifel [29] 1985 25 92 Saitoh et al [50] 1986 88 90 73 Di Candio et al [14] 1987 55 91 Accarpio et al [1] 1987 54 94 Beynon et al [6] 1988 89 92 Hildebrandt et al [31] 1988 98 89 Yamashita et al [59] 1988 122 78 Beynon et al [7] 1989 95 83 Rifkin et al [46] 1989 …”