The Role of 1.5-T MRI in Pre Operative Staging and Surgical Planning of Rectal Carcinoma
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- Category: Vol. 84, December 2016
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The Role of 1.5-T MRI in Pre Operative Staging and Surgical Planning of Rectal Carcinoma, TAMER M. ABD AL-RAHMAN, REDA TABASHY, AHMAD M. MAHMOUD and REDA S. ABD AL-LATIF
Abstract
High resolution magnetic resonance imaging plays a pivotal role in the pretreatment assessment of primary rectal cancer and post operative follow-up. Rectal cancer constitutes about one third of all gastrointestinal tumor so, high resolution MRI is the best modality to assess the relations of the rectal tumor and the potential circumferential resection margin (CRM). Our purpose was to assess the sensitivity and accuracy of 1.5-T MRI in the preoperative staging, prediction of negative circumferential resection margin and surgical planning of rectal carcinoma.
Material and Methods: Seventy-eight patients (mean age: 40 years) (45 women, 33 men) with pathologically proven rectal carcinoma were included in prospective original research study from (July 2012 to March 2014) at National Cancer Institute, Cairo university . The research proposal was approved by our Institutional Ethical Committee. All patients gave written consents. All patients underwent high-resolution pelvic MRI examination. At least five pulse sequences (axial T2, T1, and diffusion Wis together with coronal T1 and post contrast dynamic fat sat. T1 weighted gradient study) were performed in all patients. The preoperative radiological staging was done and correlated with post operative pathological data in all patients.
Results: In all 78 cases, rectal carcinoma was identified on the MRI and confirmed histologically. The MRI findings were correct in the prediction of the T stage in 75 cases (accuracy, 97.9%). While the accuracy for N stage was (94.6%).
Conclusion: MRI of rectal cancer is accurate for preop-erative staging, prediction of negative circumferential resection margin, lymph nodes involvement and planning of sphincter preserving surgery.