title: Endorectal ultrasound in the diagnosis of rectal cancer: accuracy and criticies.
abstract: BACKGROUND
  Endorectal ultrasound (ERU) is used for locoregional staging of rectal cancer. Our work compares the data in the literature regarding diagnostic accuracy of the technique and results of routine use of the technique in two centers in Piedmont.
  
  
  METHODS
  77 reports ultrasound with the final diagnosis of rectal cancer from the period 2008-2012 were examined. The echographies were performed by two experienced operators, using two ultrasound device with the same technical characteristics.
  
  
  RESULTS
  Sensitivity levels are high, with the exception of stage T3. Specificity is always high. The relationships of verisimilitude, both negative and positive, showing that the accuracy of the test is still high. The risk of overstaging is higher for pT1, while most important the risk of understaging concerns the stage T3 (23.5%); on the contrary the ERU is able to exclude infiltration of perirectal organs with a good accuracy (NPV of 99.3%).
  
  
  CONCLUSIONS
  Although our study was a retrospective study, likewise some literature's reports, the interpretation of our analysis results shows a significant risk of downstaging T3 and N+ tumors. ERU represents in our experience a very important radiological staging methods to evaluate T1 and T2 rectal cancer.
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: alessandra.sur@gmail.com.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Surace
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: alessiaferrarese.md@gmail.com.
authors.forename: Alessia
authors.initials: A
authors.lastname: Ferrarese
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: silvia.marola@gmail.com.
authors.forename: Silvia
authors.initials: S
authors.lastname: Marola
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: alexbori@libero.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Borello
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: jacopo.cumbo@gmail.com.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Cumbo
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Rivelli
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: mariosolej@gmail.com.
authors.forename: Mario
authors.initials: M
authors.lastname: Solej
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: valtermartino.md@gmail.com.
authors.forename: Valter
authors.initials: V
authors.lastname: Martino
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: marcoferronato@libero.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Ferronato
authors.affiliation: Santa Croce e Carle Hospital, Cuneo, Department of General Surgery, Italy. Electronic address: herbertdalcorso@libero.it.
authors.forename: Herbert
authors.initials: H
authors.lastname: Dal Corso
authors.affiliation: University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy. Electronic address: mario.nano@unito.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Nano
mesh_terms: D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D019160:Endosonography / Q000379:methods*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Endorectal ultrasound; Overstaging; Rectal cancer; Staging; Ultrasound