Silvia Girolama Drago, Presenter: Nothing to Disclose

Davide Ippolito MD, Abstract Co-Author: Nothing to Disclose

Pietro Andrea Bonaffini MD, Abstract Co-Author: Nothing to Disclose

Cammillo Roberto Giovanni Leopoldo Talei Franzesi, Abstract Co-Author: Nothing to Disclose

Giulia Querques MD, Abstract Co-Author: Nothing to Disclose

Sandro Sironi MD, Abstract Co-Author: Nothing to Disclose

To assess the accuracy of current generation multidetector-row CT scanner by using multiplanar reconstructions (MPR) in identifying the mesorectal fascia (MRF) invasion, in rectal cancer patients, in comparison with conventional MRI.

A total of 79 patients with biopsy proven primary adenocarcinoma of the rectum who were referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed both on a 256 row scanner (ICT, Philips) and on 16 row scanner (Brilliance 16P, Philips) with the following acquisition parameters: tube voltage 120 KV and tube current 150-300 mAs (depending on patient’s weight). Multiplanar CT reconstructions were performed and the imaging data were reviewed as axial images and then as MPR images: coronal, sagittal, perpendicular and parallel along with rectal tumour axis. The MRF was readily identified in all patients as a thin, isodense to muscle, curvilinear envelope adjacent to the rectum and the mesorectal fat. The MR study, performed on 1.5 T with a dedicated phased array multicoil, included multiplanar T2 weighted sequences and axial T1 weighted sequences. Axial and MPR CT images were then compared to MRI imaging in order to assess the involvement of MRF. Diagnostic accuracy of both modalities was compared and statistically analyzed.  

All the CT scan studies were diagnostic in terms of detection of rectal cancer; among the 79 patients, the tumor characteristics suggested by multidetector-row CT agreed with those of MRI. All the patients underwent to surgical rectal excision. Considering the row CT axial images, the overall sensitivity and specificity were respectively 82,6% and 70%, PPV was 79%, NPV 74% and accuracy of 77%; while performing multiplanar reconstructions the sensitivity increased to 87% and specificity to 85%, PPV was 89%, NPV 82% and accuracy of 86%.  

CT technique with new generation of scanner, by producing high resolution images, represents a useful and reliable diagnostic tool in the assessment of loco-regional and whole body staging of patient with locally advanced rectal cancer.

MDCT, producing higher resolution and multi-planar reformation of the images, should be considered as alternative technique in rectal cancer staging, especially in patient with MRI contraindications.

Drago, S, Ippolito, D, Bonaffini, P, Talei Franzesi, C, Querques, G, Sironi, S, Diagnostic Accuracy of Multidetector-row Computed Tomography Study in Assessment of Mesorectal Fascia Invasion for Staging of Rectal Cancer Patients in Comparison with Magnetic Resonance Imaging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14004914.html