Comparison between 3-T magnetic resonance imaging and multi-detector row computed tomography for the preoperative evaluation of rectal cancer.
OBJECTIVE
To compare prospectively between 3-T magnetic resonance imaging (MRI) and multidetector row computed tomography (MDCT) for the local staging of rectal cancer.


METHODS
During a recent 8-month period, both 3-T MRI with a phased array coil and MDCT scanner were used to preoperatively examine 31 consecutive patients. Preoperatively, the 3 experienced reviewers independently assessed the MRI and MDCT findings for the depth of tumor invasion into the rectal wall (T). Regional lymph node metastasis (N) was assessed by the 3 reviewers working in consensus. For T staging, we used a modified T staging (<or=T2, T3, and T4 staging). The results of the MRI and MDCT findings were compared based on the diagnosis of the resected specimens.


RESULTS
At histopathology, T1 was identified in 8 patients, T2 in 6, and T3 in 17 patients. The sensitivity, specificity, and accuracy for T2 staging or less between MRI and MDCT were 93% and 79%, 88% and 76%, and 91% and 77%, respectively. The sensitivity, specificity, and accuracy for T3 between MRI and MDCT were 92% and 73%, 93% and 83%, and 92% and 78%, respectively; there was a statistically significant difference for the T2 and T3 staging or less (P < 0.01). For N staging, MRI and CT can predict accurately in 88% and 77%, respectively (P > 0.05).


CONCLUSIONS
For local staging of rectal cancer, 3-T MRI is more accurate than MDCT for determining the depth of tumor invasion and the extent of lymph node metastasis.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Chan Kyo
CK
Kim
Seung Hoon
SH
Kim
Dongil
D
Choi
Min Ju
MJ
Kim
Ho-Kyung
HK
Chun
Soon Jin
SJ
Lee
Jong Mee
JM
Lee
D000368:Aged; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007413:Intestinal Mucosa / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D012007:Rectum / Q000473:pathology; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed / Q000379:methods*