Contrast-enhanced computed tomography colonography in preoperative distinction between T1-T2 and T3-T4 staging of colon cancer
| Autor: | Nicola Flor, Francesco Sardanelli, Miriam Mezzanzanica, Silvano Bosari, Simone Soldi, Andrea Pisani Ceretti, Gian Paolo Cornalba, Mauro Peri, Elena Guerini Rocco, Paolo Rigamonti |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer Contrast Media Sensitivity and Specificity symbols.namesake McNemar's test Computed Tomography Colonography Deformity Medicine Humans Radiology Nuclear Medicine and imaging Stage (cooking) Fisher's exact test Aged Neoplasm Staging Aged 80 and over business.industry Reproducibility of Results Middle Aged medicine.disease Prognosis Confidence interval Iopamidol Colonic Neoplasms Preoperative Period symbols T-stage Female Radiology medicine.symptom business Colonography Computed Tomographic |
| Zdroj: | Academic radiology. 20(5) |
| ISSN: | 1878-4046 |
| Popis: | To predict the T stage of nonrectal colon cancer using contrast-enhanced computed tomography colonography.Sixty-one patients with 67 nonrectal colon cancers consecutively underwent contrast-enhanced computed tomography colonography after an incomplete colonoscopy. Two readers evaluated wall deformity and perilesional fat abnormality on three-dimensional double contrast enema-like views and multiplanar reconstructions. Pathology was used as the standard of reference. McNemar, Fisher, and Cohen κ statistics were used.At pathologic examination, we found the following stages: T1 (n = 5), T2 (n = 10), T3 (n = 41), T4a (n = 6), and T4b (n = 5). Intraobserver and interobserver reproducibilities were almost perfect for wall deformity (κ = 1.00 and κ = 0.88, respectively), substantial for perilesional fat abnormality (κ = 0.79 and κ = 0.74, respectively). Using the results of the more experienced reader, accuracy of wall deformity ≥50% (apple-core) alone for T ≥ 3 was 62 of 67 (0.93, 95% confidence interval [CI] 0.83-0.97) and that of perilesional fat abnormality alone was 37 of 67 (0.55, 95% CI 0.43-0.67) (P.001). Predictive value for ≥ T3 of the association wall deformity ≥50% with perilesional fat abnormality was 22 of 22 (1.00, 95% CI 0.85-1.00), higher, but not significantly, than that of wall deformity ≥50% with normal perilesional fat 29 of 33 (0.88, 95% CI 0.72-0.97) (P = .148, Fisher exact test).The presence of apple-core wall deformity, regardless of perilesional fat abnormality, is highly predictive of stage T3 or higher. |
| Databáze: | OpenAIRE |
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