title: Evaluating rectal tumor staging with magnetic resonance imaging, computed tomography, and endoluminal ultrasound: A meta-analysis.
abstract: BACKGROUND
  Magnetic resonance imaging (MRI), endoluminal ultrasound (EUS), and computed tomography (CT) are commonly used imaging tools to evaluate rectal tumor staging, but there was no recent meta-analysis to define the present role of the 3 tools. Here, we proposed to systematically compare the accuracy of the 3 imaging tools for rectal tumor staging.
  
  
  METHODS
  We systematically searched diagnostic accuracy studies of MRI, CT, or EUS on rectal cancer staging, written in English or Chinese, published between January 1, 2003 and Dec 31, 2015 from database of PubMed, EMBASE, and Cochrane Library. The reference standards should be pathological findings. Hierarchical regression model was used for producing summary receiver operating characteristic (SROC) curves and calculating diagnostic accuracy data including sensitivity, specificity, and diagnostic odds ratio for the 3 imaging tools. Investigation of sample size, quality items and resolution, and magnetic field strength on heterogeneity was detected by using subgroup analysis and SROC regression.
  
  
  RESULTS
  This analysis included 89 studies. MRI, CT, and EUS yielded similar diagnostic accuracy. Better performance was observed with high-resolution MRI and 3.0-T MRI (P = 0.01 and 0.04, respectively). EUS showed lower diagnostic accuracy after preoperative therapies (P = 0.03).
  
  
  CONCLUSIONS
  MRI, CT, and EUS have comparable accuracy for rectal tumor staging. High-resolution MRI and 3.0-T MRI can produce better staging results and were recommended. EUS is not suitable for rectal tumor staging for its significantly decreased accuracy.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China.
authors.forename: Xiao-Ting
authors.initials: XT
authors.lastname: Li
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Zhang
authors.forename: Ying-Shi
authors.initials: YS
authors.lastname: Sun
authors.forename: Lei
authors.initials: L
authors.lastname: Tang
authors.forename: Kun
authors.initials: K
authors.lastname: Cao
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography