title: Preoperative staging of resectability of colon cancer using virtual colonoscopy: correlation with surgical results. Our experience.
abstract: OBJECTIVE
  To evaluate the clinical usefulness of preoperative computed tomography colonography (CTC) in locoregional staging in patients with abdominal pain secondary toocclusive colorectal cancer (CRC).
  
  
  METHODS
  80 patients with abdominal pain underwent CTC initially without contrast and after diagnosis with contrast. 47 patients had distal CRC and 33 had proximal CRC. CTimages were analyzed independently by two radiologists, using MPR reconstruction and VR images. Depending on the anatomical depth of wall invasion primary tumor (T) was classified ≤ T2, T3 and T4. The definition of node disease (N) was based on the number of involved regional lymph nodes. Metastases (M) were characterized by the presence and location of distant disease. Pre treatment stage (cT cN) was compared with pathologic stage (pT pN). Accuracy of CTC was also evaluated.
  
  
  RESULTS
  The overall accuracy values for T staging of reviewer 1, reviewer 2 and consensus reading were 91.6%, 86.2% and 92.8% respectively; 92.2%, 79.8% and 92.5% for T2; 88.1%, 85.5%, and 89.7% for T3; and 94.5%, 93.5% and 96.2% for T4. The accuracy values for N staging and M staging were 81,.8%, 94.0% for reviewer 1; 78.2% and 88.1% for reviewer 2; 81.8% and 94.0% for consensus reading, respectively.
  
  
  CONCLUSIONS
  In our experience CTC is not only useful in the evaluation of the proximal bowel, but can also provide surgeons with accurate information about staging and tumor localization. CTC is recommended for better evaluation of preoperative staging.
  
  
  BACKGROUND
  CT colonography, Colorectal cancer, Extracolonic findings, Staging.
authors.forename: Luciano
authors.initials: L
authors.lastname: Izzo
authors.forename: Luca
authors.initials: L
authors.lastname: Impara
authors.forename: Federico
authors.initials: F
authors.lastname: Pugliese
authors.forename: Monir Al
authors.initials: MA
authors.lastname: Mansour
authors.forename: Francesco
authors.initials: F
authors.lastname: De Felice
authors.forename: Carlo
authors.initials: C
authors.lastname: De Dominicis
authors.forename: Anna
authors.initials: A
authors.lastname: De Santis
authors.forename: Carlo
authors.initials: C
authors.lastname: De Felice
authors.forename: Raimondo
authors.initials: R
authors.lastname: Gabriele
authors.forename: Luigi
authors.initials: L
authors.lastname: Basso
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Di Cello
authors.forename: Maria
authors.initials: M
authors.lastname: Caputo
authors.forename: Paolo
authors.initials: P
authors.lastname: Izzo
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D023881:Colonography, Computed Tomographic / Q000379:methods; D003287:Contrast Media; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009367:Neoplasm Staging / Q000379:methods*; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000601:surgery; D015588:Observer Variation; D011300:Preoperative Care / Q000379:methods*; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media