Potentials of high resolution magnetic resonance imaging versus computed tomography for preoperative local staging of colon cancer
2013 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 54, no 7, 722-730 p.Article in journal (Refereed) Published
Background: Preoperative identification of locally advanced colon cancer is of importance in order toproperly plan treatment. Purpose: To study high resolution T2-weighted magnetic resonance imaging (MRI) versus computed tomography (CT) for preoperative staging of colon cancer with surgery and histopathology as reference standard. Material and Methods: Twenty-eight patients with a total of 29 tumors were included. Patients were examined on a 1.5 T MR unit using a phased array body coil. T2 turbo spin-echo high resolution sequences were obtained in a coronal, transverse, and perpendicular plane to the long axis of the colon at the site of the tumor. Contrast-enhanced CT was performed using a protocol for metastasis staging. The examinations were independently evaluated by two gastrointestinal radiologists using criteria adapted to imaging for prediction of T-stage, N-stage, and extramural venous invasion. Based on the T-stage, tumors were divided in to locally advanced (T3cd-T4) and not locally advanced (T1-T3ab). Surgical and histopathological findings served as reference standard. Results: Using MRI, T-stage, N-stage, and extramural venous invasion were correctly predicted for each observer in 90% and 93%, 72% and 69%, and 82% and 78% of cases, respectively. With CT the corresponding results were 79% and 76%, 72% and 72%, 78% and 67%. For MRI inter-observer agreements (Kappa statistics) were 0.79, 0.10, and 0.76. For CT the corresponding results were 0.64, 0.66, and 0.22. Conclusion: Patients with locally advanced colon cancer, defined as tumor stage T3cd-T4, can be identified by both high resolution MRI and CT, even when CT is performed with a metastasis staging protocol. MRI may have an advantage, due to its high soft tissue discrimination, to identify certain prognostic factors such as T-stage and extramural venous invasion.
Place, publisher, year, edition, pages
2013. Vol. 54, no 7, 722-730 p.
Colon cancer, staging, high resolution MRI, computed tomography, histopathology, neoadjuvant treatment
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-208049DOI: 10.1177/0284185113484018ISI: 000323511400003OAI: oai:DiVA.org:uu-208049DiVA: diva2:651116