TNM staging of gastrointestinal tumors by hydrosonography: results of a histopathologically controlled study in 60 patients.
BACKGROUND
The study is a prospective evaluation of preoperative TNM staging of gastrointestinal tumors by hydrosonography (HUS).


METHODS
Sixty patients with suspected gastric or colorectal cancer underwent HUS for TNM staging. All patients were operated on and the tumors completely removed when possible. HUS findings were correlated with histopathologic staging.


RESULTS
HUS correctly localized tumors in 75% of patients. T stage accuracy was low for gastric cancers (41%). N staging of gastric cancers was accurate in 68% of all cases and was highly specific (100%). Staging was more accurate for colorectal tumors (70%), especially with respect to infiltration of other structures (sensitivity 100%, specificity 95%). N staging, however, was not reliable, mostly owing to impaired examination conditions.


CONCLUSIONS
HUS easily misses tumors of the gastric cardia and distal part of the rectum. T staging of colorectal tumors with HUS is highly accurate, reaching 92% if the tumor is localized. T1 cancers of the stomach tend to be overstaged, and serosal infiltration by gastric cancers is often misjudged. With the exception of cardial gastric and distal rectal cancers, HUS comes close to endosonography for staging gastrointestinal tumors. HUS does not require intraluminal access.
Düx
M
M
Department of Diagnostic Radiology, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
Roeren
T
T
Kuntz
C
C
Richter
G M
GM
Kauffmann
G W
GW
D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D004326:Drinking; D004733:Enema; D006801:Humans; D009367:Neoplasm Staging; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography; D014867:Water
D014867:Water