Pelvic CT in addition to MRI to differentiate between rectal and sigmoid cancer on imaging using the sigmoid take-off as a landmark.
Acta Radiol
; 64(2): 467-472, 2023 Feb.
Article
en En
| MEDLINE
| ID: mdl-35404168
ABSTRACT
BACKGROUND:
The sigmoid take-off (STO) is a recently established landmark to discern rectal from sigmoid cancer on imaging. STO-assessment can be challenging on magnetic resonance imaging (MRI) due to varying axial planes.PURPOSE:
To establish the benefit of using computed tomography (CT; with consistent axial planes), in addition to MRI, to anatomically classify rectal versus sigmoid cancer using the STO. MATERIAL ANDMETHODS:
A senior and junior radiologist retrospectively classified 40 patients with rectal/rectosigmoid cancers using the STO, first on MRI-only (sagittal and oblique-axial views) and then using a combination of MRI and axial CT. Tumors were classified as rectal/rectosigmoid/sigmoid (according to published STO definitions) and then dichotomized into rectal versus sigmoid. Diagnostic confidence was documented using a 5-point scale.RESULTS:
Adding CT resulted in a change in anatomical tumor classification in 4/40 cases (10%) for the junior reader and in 6/40 cases (15%) for the senior reader. Diagnostic confidence increased significantly after adding CT for the junior reader (mean score 3.85 vs. 4.27; P < 0.001); confidence of the senior reader was not affected (4.28 vs. 4.25; P = 0.80). Inter-observer agreement was similarly good for MRI only (κ=0.77) and MRI + CT (κ=0.76). Readers reached consensus on the classification of rectal versus sigmoid cancer in 78%-85% of cases.CONCLUSION:
Availability of a consistent axial imaging plane - in the case of this study provided by CT - in addition to a standard MRI protocol with sagittal and oblique-axial imaging views can be helpful to more confidently localize tumors using the STO as a landmark, especially for more junior readers.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias del Recto
/
Neoplasias del Colon Sigmoide
Tipo de estudio:
Guideline
Límite:
Humans
Idioma:
En
Revista:
Acta Radiol
Año:
2023
Tipo del documento:
Article
País de afiliación:
Países Bajos