title: MRI can be used to assess advanced T-stage colon carcinoma as well as rectal carcinoma.
abstract: OBJECTIVE
  To evaluate the feasibility of assessing advanced T-stage (T3-T4) colorectal carcinomas by correlating MRI with histopathological findings.
  
  
  METHODS
  The study population comprised 31 patients with 32 lesions (22 colon and 10 rectal carcinomas). The relationship between the tumor and bowel layers on T2- and contrast-enhanced T1-weighted images (T2WI, CE-T1WI), bowel wall deformity, and the linear architecture of subserosal fat on T2WI scans was independently assessed by two radiologists. Diagnostic ability and interobserver agreement were evaluated using Fisher's exact test and kappa statistics, respectively.
  
  
  RESULTS
  The sensitivity/specificity for disrupting the outer layer on T2WI scans for the differentiation between Tis-T2 and T3-T4 colorectal carcinoma was 100/75 % (p < 0.05) for both observers; on CE-T1WI, it was 88.0/50 % (p = 0.13) for one and 96.0/50 % (p = 0.11) for the other. The sensitivity/specificity for recognizing the reticulated linear architecture to distinguish T3 from T4 colon carcinoma was 83.3/84.6 % (p < 0.05) for one reader and 100/92.3 % (p < 0.05) for the other reader.
  
  
  CONCLUSIONS
  Disruption of the outer low-intensity layer on T2WI scans was the most important finding for the diagnosis of T3-T4 colorectal carcinoma. The reticulated linear architecture of the fat tissue was suggestive of T4 colon carcinoma.
authors.affiliation: Department of Radiology, Shiga Universitiy of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. akino@belle.shiga-med.ac.jp.
authors.forename: Akitoshi
authors.identifier: http://orcid.org/0000-0002-8610-2571
authors.initials: A
authors.lastname: Inoue
authors.affiliation: Department of Radiology, Shiga Universitiy of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ohta
authors.affiliation: Department of Radiology, Shiga Universitiy of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Nitta
authors.affiliation: Department of Radiology, Shiga Universitiy of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshimura
authors.affiliation: Department of Surgery, Shiga Universitiy of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Department of Surgery, Shiga Universitiy of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Masaji
authors.initials: M
authors.lastname: Tani
authors.affiliation: Department of Pathology, Shiga Universitiy of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kushima
authors.affiliation: Department of Radiology, Shiga Universitiy of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Murata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012007:Rectum / Q000000981:diagnostic imaging / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Colonic neoplasm; Lower gastrointestinal tract; Magnetic resonance imaging; Neoplasm staging