[Comparison between endorectal MRI (EMRTI) and endorectal sonography (ES) after surgery or therapy for rectal tumors to exclude recurrent or residual tumor].
OBJECTIVE
This study was designed to evaluate the accuracy and limitations for staging of contrast-enhanced endorectal MR imaging comparing with transrectal US for restaging of rectal lesions after surgery or after therapeutic radiation. Both methods were correlated with histologic findings.


METHODS
The efficacy of these both methods was evaluated in 30 patients with supposed residual or recurrent rectal neoplasms. Contrast enhanced (bolus injection of 0.1 mmol/kg b.w. Gd-DTPA) endorectal MR imaging was performed using a 1.5 Tesla Magnetom. In addition endosonography (7.5 x or 10-MHz transducer) was used.


RESULTS
In 8 patients with rectal adenoma after electro-laser resection, 8 patients with rectal carcinoma stage pT1 after transanal resection, 8 patients with rectal carcinoma stage pT2 and 6 patients with rectal carcinoma stage pT3 after regional hyperthermia with radiochemo-therapy, the following results were obtained during the postsurgical or posttherapeutical follow-up with respect to histopathological evaluation: exact staging in 86.6 % with EMRI and 63.3 % in ES, overstaging in 8 % (EMRI) and 23 % (ES), understaging in 0 % (EMRI) and 7 % (ES). The highest diagnostic accuracy was shown in EMRT in patients with rectal adenoma and rectal carcinoma (pT1) and after electro-laser resection or transanal resection during follow-up.


CONCLUSIONS
Contrast enhanced endorectal MR imaging appears to be very promising for accurate posttherapeutical staging of rectal cancer and helpful in the diagnosis of recurrence or the differentiation between scar tissue and residual rectal tumor.
Pegios
W
W
Institut für Diagnostische und Interventionelle Radiologie, Berlin, Germany.
Hünerbein
M
M
Schröder
R
R
Wust
P
P
Schlag
P
P
Felix
R
R
Vogl
T J
TJ
D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D019160:Endosonography / Q000295:instrumentation*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000175:diagnosis* / Q000473:pathology; D011351:Proctoscopy; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D012007:Rectum / Q000473:pathology; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
Vergleich zwischen endorektaler MRT (EMRT) und endorektaler Sonographie (ES) postoperativ bzw. posttherapeutisch bei rektalen Tumoren zum Ausschluss von Rezidiv- bzw. Residualtumoren.