Mezzi G, Arcidiacono PG, Carrara S, Perri F, Petrone MC, De Cobelli F, Gusmini S, Staudacher C, Del Maschio A, Testoni PA. Endoscopic ultrasound and magnetic resonance imaging for re-staging rectal cancer after radiotherapy. World J Gastroenterol 2009; 15(44): 5563-5567 [PMID: 19938195 DOI: 10.3748/wjg.15.5563]
Corresponding Author of This Article
Gianni Mezzi, MD, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Vita-Salute University, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy. mezzi.gianni@hsr.it
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World J Gastroenterol. Nov 28, 2009; 15(44): 5563-5567 Published online Nov 28, 2009. doi: 10.3748/wjg.15.5563
Endoscopic ultrasound and magnetic resonance imaging for re-staging rectal cancer after radiotherapy
Gianni Mezzi, Paolo Giorgio Arcidiacono, Silvia Carrara, Francesco Perri, Maria Chiara Petrone, Francesco De Cobelli, Simone Gusmini, Carlo Staudacher, Alessandro Del Maschio, Pier Alberto Testoni
Gianni Mezzi, Paolo Giorgio Arcidiacono, Silvia Carrara, Maria Chiara Petrone, Pier Alberto Testoni, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Vita-Salute University, San Raffaele Scientific Institute, 20132 Milan, Italy
Francesco Perri, Gastroenterology Unit, San Benedetto del Tronto Hospital, 63039 San Benedetto del Tronto (AP), Italy
Francesco De Cobelli, Simone Gusmini, Alessandro Del Maschio, Department of Radiology, IRCCS Vita-Salute University, San Raffaele Scientific Institute, 20132 Milan, Italy
Carlo Staudacher, Department of Surgery, IRCCS Vita-Salute University, San Raffaele Scientific Institute, 20132 Milan, Italy
Author contributions: Mezzi G, Arcidiacono PG, Carrara S, Perri F, Petrone MC, De Cobelli F, Gusmini S, Staudacher C, Del Maschio A and Testoni PA contributed equally to this work; Mezzi G and Arcidiacono PG designed the research; Mezzi G and Perri F analyzed the data; Mezzi G wrote the paper.
Correspondence to: Gianni Mezzi, MD, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Vita-Salute University, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy. mezzi.gianni@hsr.it
Telephone: +39-2-26432744 Fax: +39-2-26432504
Received: August 4, 2009 Revised: October 1, 2009 Accepted: October 8, 2009 Published online: November 28, 2009
Abstract
AIM: To compare the sensitivity and specificity of two imaging techniques, endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI), in patients with rectal cancer after neoadjuvant chemoradiation therapy. And we compared EUS and MRI data with histological findings from surgical specimens.
METHODS: Thirty-nine consecutive patients (51.3% Male; mean age: 68.2 ± 8.9 years) with histologically confirmed distal rectal cancer were examined for staging. All patients underwent EUS and MRI imaging before and after neoadjuvant chemoradiation therapy.
RESULTS: After neoadjuvant chemoradiation, EUS and MRI correctly classified 46% (18/39) and 44% (17/39) of patients, respectively, in line with their histological T stage (P > 0.05). These proportions were higher for both techniques when nodal involvement was considered: 69% (27/39) and 62% (24/39). When patients were sorted into T and N subgroups, the diagnostic accuracy of EUS was better than MRI for patients with T0-T2 (44% vs 33%, P > 0.05) and N0 disease (87% vs 52%, P = 0.013). However, MRI was more accurate than EUS in T and N staging for patients with more advanced disease after radiotherapy, though these differences did not reach statistical significance.
CONCLUSION: EUS and MRI are accurate imaging techniques for staging rectal cancer. However, after neoadjuvant RT-CT, the role of both methods in the assessment of residual rectal tumors remains uncertain.
