Pre-operative assessment of extramural invasion and sphincteral involvement in rectal cancer by magnetic resonance imaging with phased-array coil.
OBJECTIVE
Pre-operative staging of rectal cancer should identify patients with extrarectal spread, who might benefit from pre-operative radiotherapy, and patients with minimal sphincteral involvement, who can avoid permanent colostomy. The aim of this study was to assess the accuracy of Magnetic Resonance Imaging (MRI) to predict tumour stage and sphincter status.


METHODS
Thirty-three patients with a rectal tumour were pre-operatively assessed by MRI with a phased-array coil. Imaging results were correlated with the final pathological findings.


RESULTS
The overall accuracy of pre-operative staging with MRI was 88% (k = 0.75) for extramural tumour invasion and 59% (k = 0.26) for lymph node metastases. MRI correctly evaluated the infiltration of the anal sphincters in 87% of patients (7 of 8 patients with low rectal tumour).


CONCLUSIONS
MRI provides the surgeon with valuable information regarding extramural tumour spread and sphincteral involvement, enabling appropriate selection of patients for pre-operative adjuvant therapy or sphincter-saving surgery.
Ferri
M
M
Department of Surgery P.Valdoni, University of Rome - La Sapienza, Rome, Italy. mario.ferri@uniromal.it
Laghi
A
A
Mingazzini
P
P
Iafrate
F
F
Meli
L
L
Ricci
F
F
Passariello
R
R
Ziparo
V
V
D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003082:Colectomy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery