Accuracy of water-enema multidetector computed tomography (WE-MDCT) in colon cancer staging: a prospective study

Autor: Aurélien Venara, A. H. Pavageau, Catherine Ridereau-Zins, E. Metivier-Cesbron, E. Sibileau, Christophe Aubé, Sandrine Bertrais, D. Vanel
Přispěvatelé: Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)
Rok vydání: 2014
Předmět:
Adult
Male
medicine.medical_specialty
Colon
Colorectal cancer
Iohexol
[SDV]Life Sciences [q-bio]
Urology
Contrast Media
Colonoscopy
Enema
TNM staging system
Colon cancer staging
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
Abdominal wall
03 medical and health sciences
0302 clinical medicine
Hounsfield scale
Multidetector Computed Tomography
Preoperative Care
Image Processing
Computer-Assisted
medicine
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
Stage (cooking)
Lymph node
Aged
Neoplasm Staging
Aged
80 and over
Radiological and Ultrasound Technology
medicine.diagnostic_test
business.industry
Gastroenterology
Water
General Medicine
Middle Aged
medicine.disease
3. Good health
Radiographic Image Enhancement
medicine.anatomical_structure
030220 oncology & carcinogenesis
Colonic Neoplasms
Female
Radiology
business
Zdroj: Abdominal Imaging
Abdominal Imaging, Springer Verlag, 2014, 39 (5), pp.941-8. ⟨10.1007/s00261-014-0150-9⟩
ISSN: 1432-0509
0942-8925
DOI: 10.1007/s00261-014-0150-9
Popis: International audience; PurposeTo assess the accuracy of water-enema multidetector computed tomography (WE-MDCT) in extra-rectal colon cancer staging.Materials and methodsFifty-three patients (mean age 70years) with extra-rectal colon cancer proven by colonoscopy and biopsy were prospectively evaluated by preoperative WE-MDCT. CT scans were both intraluminal (water enema or WE) and intravenous (iodinated) contrast enhanced (CE). All patients underwent surgery. Tumors were classified with the TNM staging system. Noted CT features were: tumor size and location; tumor form and edges; spread to the pericolic fat or neighboring organs; thickening of retroperitoneal fascia; number, size, and enhancement of the peritumoral lymph nodes. Tumors were classified on CT into 3 T-stage groups: T1/T2, T3, and T4. Lymph nodes were classified by their density after injection [positive over 100 Hounsfield units (HU)].ResultsTumor localization to the specific colon segment was correct in all the cases. The agreement between WE-MDCT staging and histopathology staging was good (k=0.64). An irregular and bowl-shaped aspect of the external edges of tumor provided excellent sensitivity for T3/T4 inclusion (Se 97.7%, NPV 85.7%). Thickening of a fascia or the abdominal wall provided good specificity for T4 stage (Sp 88.1%, NPV 94.9%). Enhancement over 100HU of at least one peritumoral lymph node was the best criterion of N+ staging (Sp 67.7%, NPV 87.5%).ConclusionWE-MDCT permits good staging of colon cancer based on objective features.
Databáze: OpenAIRE
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