INTRODUCTIONColorectal cancer is the third most common cancer in both men and women.(1) The pathological stage of the cancer is the most important predictive factor of overall survival in patients with colorectal cancer.(2,3) Between 1.5% and 9.0% of patients with colorectal carcinoma have a second synchronous cancer, and 27%-55% have multiple coexistent adenomatous polyps. (4) Evaluation of the entire colon and accurate preoperative staging are essential for the optimal treatment and surgical planning of colorectal cancers. This also helps to identify patients who may benefit from chemoradiation.(5) In patients with synchronous liver metastases, studies have shown that simultaneous hepatic resection is suitable for patients with 0-3 colorectal lymph node metastases, whereas neoadjuvant chemotherapy prior to resection may be more suitable for patients with ≥ 4 colorectal lymph node metastases. (6) As the low spatial and contrast resolution of conventional computed tomography (CT) protocols does not allow detailed evaluation, CT is not recommended for colorectal cancer staging. (7,8) However, multidetector computed tomography (MDCT), an advancement of CT technology, can acquire multiple simultaneous slices in a single breath-hold. Its advantages include faster scanning time, better spatial resolution, lesser motion artefacts and volume imaging. Volume imaging allows for the acquisition of either thinner or thicker sections from the same raw data, thus improving three-dimensional reconstructions and multiplanar reformation capability. (8) In MDCT colonography, the volumetric data of the large bowel obtained via high-resolution helical CT is analysed using specialised computer software to generate endoluminal images. The advantages of MDCT colonography over conventional colonoscopy include the former's noninvasive nature (which leads to better patient compliance), the ability to visualise the entire colon (conventional colonoscopy fails in 5% of cases), the absence of blind areas, and the ability to evaluate extracolonic pathology.(9) MDCT colonography also allows: (a) simultaneous assessment of colonic mucosal surface, depth of wall invasion, pericolic lymph nodes, surrounding structures and proximal colon in patients with occlusive carcinoma; and (b) the identification of synchronous carcinomas and/or coexisting adenomatous polyps, which could influence the treatment plan. (4,10) While several studies have proven that CT colonography can be used to screen for colorectal cancer, (9)(10)(11) few studies have evaluated whether contrast-enhanced MDCT colonography (CEMDCTC) is valuable for preoperative staging of colorectal cancer. (9,11) The present study aimed to compare the accuracy of colorectal cancer staging done using CEMDCTC against that done using surgery and histopathology.