Preoperative T and N staging of colorectal cancer: accuracy of contrast-enhanced multi-detector row CT colonography--initial experience

Radiology. 2004 Apr;231(1):83-90. doi: 10.1148/radiol.2311021152. Epub 2004 Feb 27.

Abstract

Purpose: To evaluate the accuracy of contrast material-enhanced multi-detector row computed tomographic (CT) colonography for preoperative staging of colorectal cancer.

Materials and methods: Forty-one patients with colorectal carcinoma underwent preoperative contrast-enhanced multi-detector row CT colonography. Images were obtained in the arterial (start delay of 35 seconds) and portal venous (start delay of 70 seconds) phases. The arterial phase was focused on the suspected region of neoplasm, whereas the venous phase included the whole abdomen and pelvis. Two radiologists independently evaluated the depth of tumor invasion into the colorectal wall (T) and regional lymph node involvement (N) on transverse CT images alone and in combination with multiplanar reformations (MPRs). Disagreements were resolved by means of consensus. CT findings were compared with pathologic results, which served as the reference standard. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were assessed. Differences in accuracy for T and N staging were assessed by using the McNemar test.

Results: In T staging, overall accuracy was 73% when transverse images were evaluated alone and 83% when they were evaluated in combination with MPRs. This difference was not significant. N staging was associated with an overall accuracy of 59% with transverse images alone and 80% with combined transverse and MPR images (P <.01).

Conclusion: Contrast-enhanced multi-detector row CT colonography is an accurate technique for preoperative local staging of colorectal tumors.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colonography, Computed Tomographic
  • Colorectal Neoplasms / diagnostic imaging
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery*
  • Contrast Media
  • Digestive System Surgical Procedures*
  • Female
  • Humans
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Observer Variation
  • Predictive Value of Tests
  • Preoperative Care*
  • Prospective Studies
  • Radiographic Image Interpretation, Computer-Assisted
  • Sensitivity and Specificity

Substances

  • Contrast Media