title: Water-enema multidetector computed tomography for planning surgery.
abstract: OBJECTIVE
  Water-enema multidetector computed tomography (WE-MDCT) is a technique for the localization and preoperative T- and N-stage assessments of colon cancer. It may be a useful tool for planning surgery. The primary aim of this study was to evaluate the diagnostic accuracy of WE-MDCT for T-staging and its ability to locate tumors for laparoscopy planning. The secondary aim was to assess reading reproducibility and diagnostic accuracy for the preoperative determination of N-stage.
  
  
  METHODS
  We performed a study to evaluate preoperative WE-MDCT for surgical planning in patients with symptomatic colon adenocarcinomas who underwent surgery between June 2010 and January 2014. A radiologist and a surgeon read the WE-MDCTs separately. Results were compared with colonoscopy and the surgical specimen.
  
  
  RESULTS
  Seventy-one patients (42 men (59.1%); mean age 73.1 years (range 45 to 95)) were included. Seventy-six tumors were assessed. The intraclass correlation coefficient (ICC) for location as determined by surgery and that determined by WE-MDCT was 1, and the ICC for location between colonoscopy and WE-MDCT was 0.85 (95% CI 0.75-0.91). For T-stage determination, sensitivity was 96 and 94% and specificity 83 and 88% for readers 1 and 2, respectively. The T-stage assessment allowed for the programing of surgical access and showed good sensitivity and specificity for the assessment of invasion in adjacent organs.
  
  
  CONCLUSIONS
  WE-MDCT is relatively easy to perform, and its results can be read effectively by radiologists and surgeons. WE-MDCT indicated the location of tumors perfectly and permitted a good determination of their T-stage. The technique is thus pertinent for the planning of laparoscopic surgery for colon cancer.
authors.affiliation: L'UNAM, University of Angers, Angers, France, auvenara@yahoo.fr.
authors.forename: A
authors.initials: A
authors.lastname: Venara
authors.forename: C
authors.initials: C
authors.lastname: Ridereau-Zins
authors.forename: L
authors.initials: L
authors.lastname: Toque
authors.forename: E
authors.initials: E
authors.lastname: Cesbron
authors.forename: S
authors.initials: S
authors.lastname: Michalak
authors.forename: E
authors.initials: E
authors.lastname: Lermite
authors.forename: C
authors.initials: C
authors.lastname: Aube
authors.forename: A
authors.initials: A
authors.lastname: Hamy
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects / Q000379:methods; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D003113:Colonoscopy / Q000379:methods; D017558:Elective Surgical Procedures / Q000379:methods; D004733:Enema / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014867:Water
chemical_list: D014867:Water