Endoluminal ultrasound versus magnetic resonance imaging in assessment of rectal cancer after neoadjuvant therapy

Elsayed Ghoneem; Ahmed Shekeib Abdein Shabana; Mohamed El Sherbini; Mohammad Zuhdy; Osama Eldamshety; Mohamed Gouda; Ahmed El Shamy; Gehad Ahmad Saleh; Ahmed Abdel Ghafar Saleh

doi:10.1186/s12876-022-02628-9

Endoluminal ultrasound versus magnetic resonance imaging in assessment of rectal cancer after neoadjuvant therapy

BMC Gastroenterol. 2022 Dec 27;22(1):542. doi: 10.1186/s12876-022-02628-9.

Authors

Elsayed Ghoneem^{1

2}, Ahmed Shekeib Abdein Shabana¹, Mohamed El Sherbini¹, Mohammad Zuhdy³, Osama Eldamshety³, Mohamed Gouda⁴, Ahmed El Shamy⁵, Gehad Ahmad Saleh⁶, Ahmed Abdel Ghafar Saleh⁷

Affiliations

¹ Department of Internal Medicine, Hepatology and Gastroenterology Unit, Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
² Egyptian Liver Research Institute and Hospital, Sherbin, Mansoura, Egypt.
³ Department of Surgical Oncology, Oncology Center Mansoura University (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt.
⁴ Theodor Bilharz Research Institute, Cairo, Egypt.
⁵ Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
⁶ Department of Diagnostic Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
⁷ Department of Internal Medicine, Hepatology and Gastroenterology Unit, Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt. drahmedsaleh1981@gmail.com.

Abstract

Background: Accurate rectal tumor staging guides the choice of treatment options. EUS and MRI are the main modalities for staging.

Aim of the work: To compare the performance of EUS and MRI for loco-regional staging of anorectal cancer after neo-adjuvant therapy.

Methods: Seventy-three (37 male, 36 female) patients with rectal cancer after neo-adjuvant chemoradiotherapy were enrolled. Histopathological staging after surgery were used as reference for comparing the yield of loco-regional staging for EUS and MRI. EUS and MRI were done 1 month after completion of neo-adjuvant therapy.

Results: Regarding post-surgical T staging, eight patients had early tumor (T2 = 16 and T1 = 9) and thirty six were locally advanced (T3 = 36), while N staging, forty patients with negative nodes and 33 were positive (N1 = 22 and N2 = 11). Comparing EUS to MRI, it showed a higher sensitivity (95.7% vs. 78.7%), specificity (84.6% vs. 68.0%) and accuracy (91.8% vs. 75.3%) for staging early and locally advanced tumor. Also, it had a higher sensitivity (78.8% vs. 69.7%), specificity (75.0% vs. 65.0%) and accuracy (76.7% vs. 67.1%) for detection of lymph nodes.

Conclusion: EUS appears to be more accurate than MRI in loco-regional staging of rectal carcinoma after neo-adjuvant therapy.

Keywords: Colorectal cancer; EUS; Neo-adjuvant therapy.

MeSH terms

Anus Neoplasms* / pathology
Endosonography / methods
Female
Humans
Magnetic Resonance Imaging / methods
Male
Neoadjuvant Therapy
Neoplasm Staging
Rectal Neoplasms* / diagnostic imaging
Rectal Neoplasms* / pathology
Rectal Neoplasms* / therapy
Sensitivity and Specificity