title: Staging of colorectal cancer using contrast-enhanced multidetector computed tomographic colonography.
abstract: BACKGROUND
  Preoperative staging is essential for the optimal treatment and surgical planning of colorectal cancers. This study was aimed to evaluate the accuracy of colorectal cancer staging done using contrast-enhanced multidetector computed tomographic colonography (CEMDCTC).
  
  
  METHODS
  We recruited 25 patients with 28 proven colorectal cancers. A 16-slice multidetector computed tomography scanner was used to generate two-dimensional multiplanar reformatted sagittal, coronal and oblique coronal images, and three-dimensional virtual colonography (endoluminal) images. Axial and reformatted views were analysed, and TNM staging was done. Patients underwent surgery and conventional colonoscopy, and surgical histopathological correlation was obtained.
  
  
  RESULTS
  The diagnostic accuracies for TNM colorectal cancer staging were 92.3% for T staging, 42.3% for N staging and 96.1% for M staging using CEMDCTC. There was excellent positive correlation for T staging between CEMDCTC and both surgery (κ-value = 0.686) and histopathology (κ-value = 0.838) (p < 0.0001), and moderate positive correlation for N staging between CEMDCTC and surgery (κ-value = 0.424; p < 0.0001). The correlation between CEMDCTC and histopathology for N staging was poor (κ-value = 0.186; p < 0.05); the negative predictive value was 100% for lymph node detection. Moderate positive correlation was seen for M staging between CEMDCTC and both surgery (κ-value = 0.462) and histopathology (κ-value = 0.649). No false negatives were identified in any of the M0 cases.
  
  
  CONCLUSIONS
  CEMDCTC correlated well with pathologic T and M stages, but poorly with pathologic N stage. It is an extremely accurate tool for T staging, but cannot reliably distinguish between malignant lymph nodes and enlarged reactive lymph nodes.
authors: Srikala
authors: S
authors: Narayanan
authors: Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India. navkal2004@yahoo.com.
authors: Naveen
authors: N
authors: Kalra
authors: Anmol
authors: A
authors: Bhatia
authors: Jaidev
authors: J
authors: Wig
authors: Surinder
authors: S
authors: Rana
authors: Deepak
authors: D
authors: Bhasin
authors: Kim
authors: K
authors: Vaiphei
authors: Niranjan
authors: N
authors: Khandelwal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023881:Colonography, Computed Tomographic / Q000379:methods / Q000592:standards*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000592:standards*; D009367:Neoplasm Staging / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult
chemical_list: D003287:Contrast Media
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