| Optimal methods for staging rectal cancer. | |
| | |
MedLine Citation:
|
PMID: 18006793 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
At present, several modalities exist for the preoperative staging of rectal lesions, including computed tomography (CT), body coil or endorectal coil magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS) done by rigid or flexible probes, and positron emission tomography (PET). Staging accuracy for CT ranges from 53% to 94% for T-stage accuracy and from 54% to 70% for N-stage accuracy. Improved CT accuracy is observed at higher disease stages. Body coil MRI has shown T- and N-stage accuracy ranging from 59% to 95% and 39% to 95%, respectively. Endorectal coil MRI has shown improved T- and N-stage accuracy, with rates of 66% to 91% and 72% to 79%, respectively. The development of phased-array MRI, combining high spatial resolution with a larger field of view, offers promise to improve on these rates. EUS, considered the current gold standard, has shown T-stage accuracy ranging from 75% to 95%, with N-stage accuracy ranging from 65% to 80%. Flexible EUS probes have the advantage of being able to access and sample iliac nodes. Recent studies also suggest that three-dimensional EUS may provide greater accuracy than conventional two-dimensional EUS. Limited studies exist on the use of PET in primary tumor staging. PET may upstage disease in 8% to 24% of patients and has also been used in posttreatment restaging and surveillance. Postradiation edema, necrosis, and fibrosis seem to decrease restaging accuracy in all modalities. This article reviews the current literature about the staging accuracy of the various modalities and suggests a staging algorithm for rectal cancer. |
| | |
Authors:
|
V Raman Muthusamy; Kenneth J Chang |
Related Documents
:
|
16626793 - The impact of pet/ct in the management of recurrent ovarian cancer. 19304693 - Helical ct evaluation of the preoperative staging of gastric cancer in the remnant stom... 15627593 - Functional activation within the pi-dwi mismatch region in recovery from ischemic strok... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Clinical cancer research : an official journal of the American Association for Cancer Research Volume: 13 ISSN: 1078-0432 ISO Abbreviation: Clin. Cancer Res. Publication Date: 2007 Nov |
Date Detail:
|
Created Date: 2007-11-16 Completed Date: 2008-01-03 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9502500 Medline TA: Clin Cancer Res Country: United States |
Other Details:
|
Languages: eng Pagination: 6877s-84s Citation Subset: IM |
Affiliation:
|
H H Chao Comprehensive Digestive Disease Center, Chao Family Comprehensive Cancer Center, Department of Medicine, University of California, Irvine Medical Center, Orange, CA 92868, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Endosonography Humans Magnetic Resonance Imaging Neoadjuvant Therapy Neoplasm Staging Positron-Emission Tomography Rectal Neoplasms / pathology* Tomography, X-Ray Computed |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Newer pathologic assessment techniques for colorectal carcinoma.
Next Document: Management of early rectal T1 and T2 cancers.