Preoperative T staging of colorectal cancer by CT colonography.
OBJECTIVE
This study was designed to estimate the accuracy of CT colonography for the assessment of T stage in colorectal cancer.


METHODS
CT colonograms obtained from 246 lesions were reviewed by 3 investigators. Intestinal wall deformity on shaded-surface display and rough appearance around the intestine were studied to assess their relations to T stage. Intestinal wall deformity was classified into arc type, trapezoid type, and apple-core type, defined as a trapezoidal wall deformity involving > or = 50 percent of the circumference of the lumen.


RESULTS
As for intestinal wall deformity, the rate of arc type was higher in Tis/T1 than in T2 (74 percent: 17/23 vs. 24 percent: 8/34, P < 0.0001); the rate of trapezoid type was 17 percent (4/23) in Tis/T1, 59 percent (20/34) in T2, and 15 percent (28/189) in T3/T4 (Tis/T1 vs.T2, P < 0.0001; T2 vs. T3/T4, P < 0.0001); and the rate of apple-core type was lower in T2 than in T3/T4 (18 percent: 6/34 vs. 81 percent: 154/189, P < 0.0001). Arc type, trapezoid type, and apple-core type were primarily associated with T1, T2, and T3/T4, respectively. When these criteria were used, the overall accuracy for T stage was 79 percent. Rough appearance was specific for T3/T4, but insensitive.


CONCLUSIONS
CT colonography can provide important information for the preoperative assessment of T stage in colorectal cancer.
Utano
Kenichi
K
Department of Radiology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Endo
Kazuhiro
K
Togashi
Kazutomo
K
Sasaki
Junichi
J
Kawamura
Hiroshi J
HJ
Horie
Hisanaga
H
Nakamura
Yosikazu
Y
Konishi
Fumio
F
Sugimoto
Hideharu
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001706:Biopsy; D016009:Chi-Square Distribution; D023881:Colonography, Computed Tomographic; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D003287:Contrast Media