Role of 64 slice mdct with addition of single T2W sequence on 1.5 tesla mri in local staging of rectal carcinoma

Sripathi, Smiti and Rajagopal, KV and Paruthikunnan, Samir Mustaffa (2016) Role of 64 slice mdct with addition of single T2W sequence on 1.5 tesla mri in local staging of rectal carcinoma. International Journal of Contemporary Medical Research, 3 (4). pp. 1032-1035. ISSN 2454-7379

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Abstract

Introduction: The local staging of rectal cancer is crucial for prognosis and treatment planning. It aims at determining the exact extent of the tumour and helps the clinician in deciding whether surgery alone or surgery in combination with neoadjuvant chemotherapy should be offered to the patient. The study was done to compare the accuracy of 64 slice MDCT with 1.5T T2W sequence in local staging of biopsy proven cases of rectal carcinoma, to assess the agreement between MDCT and MRI in local staging with histopathological staging and to assess the agreement between the imaging modalities (MDCT and MRI) in local staging of rectal cancer in all patients. Material and methods: This prospective study was conducted from November 2012 to August 2014 wherein 41 biopsy proven cases of rectal carcinoma were evaluated with Dual phase MDCT and T2W MRI. The local staging was performed and correlated with histopathology which was taken as the gold standard. Results: The overall accuracy of MRI (89 %) was marginally better than MDCT (83 %) in detecting the invasion of the tumour however no comparable difference in the accuracy was found in detection of metastatic perirectal nodes (50%). As compared to histopathology, kappa value for T staging on MDCT was 0.7 (substantial agreement) and was 0.8 (good agreement) for MRI. While the kappa value for N staging on MDCT is 0.3, indicating a fair agreement between MRI and MDCT and histopathological nodal staging. There was a good agreement between the imaging modalities in local staging (K=0.75) with respect to Tumour staging and a very good agreement in local nodal staging (K=0.88). Conclusion: The accuracy of MRI is marginally better than MDCT in detecting invasion of the tumour with no comparable difference in detection of perirectal metastatic lymph nodes. The agreement of MRI with histopathology was better for tumour staging, with both modalities demonstrating a fair agreement for nodal staging. The agreement between the imaging modalities was substantial for tumour staging and very good for nodal staging.

Item Type: Article
Uncontrolled Keywords: Rectal; carcinoma; cancer; local staging; MDCT; MRI.
Subjects: Medicine > KMC Manipal > Radiology
Depositing User: KMC Library
Date Deposited: 25 Mar 2017 04:13
Last Modified: 25 Mar 2017 04:13
URI: http://eprints.manipal.edu/id/eprint/148565

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