EUS and magnetic resonance imaging in the staging of rectal cancer: a prospective and comparative study

Fernández‐Esparrach, Glòria; Ayuso-Colella, Juan Ramón; Sendino, Oriol; Pagés, Mario; Cuatrecasas, Míriam; Pellisé, María; Maurel, Joan; Ayuso-Colella, C; González-Suárez, Begoña; Llach, Josep; Castells, Antoni; Ginès, Pere

doi:10.1016/j.gie.2011.03.1257

Cited by 93 publications

(58 citation statements)

References 34 publications

(37 reference statements)

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“…It can better define the anatomic relation of the tumor to the mesorectal fascia and assess the circumferential resection margin (CRM) involvement, which is not possible to be defined with ERUS. Moreover, MRI can permit the study of high and/or stenotic tumors, for which staging with ERUS is known to be challenging [16,26]. …”

Section: Discussionmentioning

confidence: 99%

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

et al. 2015

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Background: Endorectal ultrasound (ERUS) is considered reliable in staging rectal cancer, but recently some critics have questioned its accuracy. The aim of this study was to evaluate how often an ERUS-based decision leads to an appropriate treatment. Methods: Two hundred and twenty patients with rectal cancer staged with ERUS who underwent a surgical resection or a local excision without neoadjuvant therapy from 1997 to 2012 were included. According to ERUS, patients were divided into three groups of indication: (a) local excision (Tis-1 N0), (b) direct surgery (T2 N0), (c) preoperative chemoradiation (T3-4 or N+). Accuracy was explored by the correlation established with the final pathology. Results: Accuracy for T and N staging was 65 and 64%, respectively. Indication to local excision and to chemoradiation was correct in 97 and 88% of patients staged by ERUS. Accuracy of indication to direct surgery was poor (37%), and 21% of patients were overtreated in this group. Conclusions: ERUS seems not able to fulfill all the needs of ideal tailored therapeutic strategies. T2 diagnosis needs to be confirmed by an excisional biopsy before a final decision is made because overstaging of early tumors may occur in a not-so-negligible proportion of patients.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2015

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“…A meta-analysis of 90 articles (1995-2002) compared the utility of MRI, radial EUS without FNA, and CT for staging with histopathology correlation as the gold standard and came to the following conclusions: For T1/T2 lesions, EUS and MRI had similar sensitivity, but specificity was higher in EUS (86 vs. 69 %); for T3 tumors, the sensitivity of EUS was significantly higher than that of MRI or CT [43]. A more recent prospective study comparing radial EUS to MRI revealed that MRI was unable to visualize any T1 tumor, whereas EUS understaged all T4 tumors [44]. Furthermore, the presence of luminal stenosis and polypoid morphology was inversely associated with accuracy for either EUS or MRI.…”

Section: Mri Versus Eus Assessmentmentioning

confidence: 99%

Rectal Cancer and Anal Sphincter Disorders

Gleeson

Levy

2015

ERCP and EUS

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“…Possible reasons for these deviations includes: 1) it was difficult to choose the same section for both the ultrasound measurement and pathology measurement; 2) the muscularis propria may have been completely replaced by the tumor over a wide area, which could make measuring the EMI more difficult (21); 3) peritumoral inflammation and real transmural tumor extension cannot easily, reliably, or precisely distinguished on ultrasound, which commonly results in overestimation of the uEMI (24-26); and 4) bulky tumors can lie outside the focal length of the transducer (27).…”

Section: Pathological Stage -----------------------------------------mentioning

confidence: 99%

Value of endorectal ultrasonography in measuring the extent of mesorectal invasion and substaging of T3 stage rectal cancer

et al. 2017

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Abstract. The present study aimed to determine the value of endorectal ultrasound (ERUS) and magnetic resonance imaging (MRI) for T3 rectal cancer, and substaging of T3 rectal cancer by measuring the extent of mesorectal invasion (EMI). The clinical data of patients with rectal cancer who were admitted to the general surgical department of Peking Union Medical College Hospital (Beijing, China) were reviewed and analyzed. Two ultrasound practitioners independently measured the EMI on ERUS, and a radiologist measured the EMI on MRI. The consistency of ERUS measurements between the two doctors was assessed using intraclass consistency (ICC) analysis. T3 stages were subdivided into T3a (EMI ≤5 mm) and uT3b (EMI >5 mm). The accuracy of MRI and ERUS in T3 rectal cancer, and T3 substaging of rectal cancer was assessed and compared according to the pathological results. The Bland-Altman scatter plot demonstrated good consistency between the ERUS measurement and pathology measurement. Furthermore, the consistency of the ERUS measurement between the two doctors was good (ICC, 0.9344; 95% confidence interval, 0.8789-0.9645). The diagnostic accuracies for T3 rectal cancer, for the two ultrasound doctors and for MRI were 86.9% (53/61), 85.2% (52/61), and 90.2% (55/61), respectively. The accuracy, sensitivity and specificity for the two individual ultrasound doctors in the substaging of T3 tumors were 79.1% (34/43), 66.7% (10/15), and 85.7% (24/28), compared with 67.4% (31/43), 60% (9/15), and 82.1% (23/28), respectively. The accuracy of MRI in the substaging of T3 tumors was 86.0% (37/43), which was not statistically higher compared with those of ERUS (P>0.05). In conclusion, ERUS is a valuable tool for measuring the EMI and substaging T3 rectal cancer, and thus, can be complementary to MRI in selecting the appropriate treatment for rectal cancer.

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EUS and magnetic resonance imaging in the staging of rectal cancer: a prospective and comparative study

Cited by 93 publications

References 34 publications

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

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

Rectal Cancer and Anal Sphincter Disorders

Value of endorectal ultrasonography in measuring the extent of mesorectal invasion and substaging of T3 stage rectal cancer

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