Pelvic CT in addition to MRI to differentiate between rectal and sigmoid cancer on imaging using the sigmoid take-off as a landmark.


Journal

Acta radiologica (Stockholm, Sweden : 1987)
ISSN: 1600-0455
Titre abrégé: Acta Radiol
Pays: England
ID NLM: 8706123

Informations de publication

Date de publication:
Feb 2023
Historique:
pubmed: 12 4 2022
medline: 9 2 2023
entrez: 11 4 2022
Statut: ppublish

Résumé

The sigmoid take-off (STO) is a recently established landmark to discern rectal from sigmoid cancer on imaging. STO-assessment can be challenging on magnetic resonance imaging (MRI) due to varying axial planes. To establish the benefit of using computed tomography (CT; with consistent axial planes), in addition to MRI, to anatomically classify rectal versus sigmoid cancer using the STO. A senior and junior radiologist retrospectively classified 40 patients with rectal/rectosigmoid cancers using the STO, first on MRI-only (sagittal and oblique-axial views) and then using a combination of MRI and axial CT. Tumors were classified as rectal/rectosigmoid/sigmoid (according to published STO definitions) and then dichotomized into rectal versus sigmoid. Diagnostic confidence was documented using a 5-point scale. Adding CT resulted in a change in anatomical tumor classification in 4/40 cases (10%) for the junior reader and in 6/40 cases (15%) for the senior reader. Diagnostic confidence increased significantly after adding CT for the junior reader (mean score 3.85 vs. 4.27; Availability of a consistent axial imaging plane - in the case of this study provided by CT - in addition to a standard MRI protocol with sagittal and oblique-axial imaging views can be helpful to more confidently localize tumors using the STO as a landmark, especially for more junior readers.

Sections du résumé

BACKGROUND BACKGROUND
The sigmoid take-off (STO) is a recently established landmark to discern rectal from sigmoid cancer on imaging. STO-assessment can be challenging on magnetic resonance imaging (MRI) due to varying axial planes.
PURPOSE OBJECTIVE
To establish the benefit of using computed tomography (CT; with consistent axial planes), in addition to MRI, to anatomically classify rectal versus sigmoid cancer using the STO.
MATERIAL AND METHODS METHODS
A senior and junior radiologist retrospectively classified 40 patients with rectal/rectosigmoid cancers using the STO, first on MRI-only (sagittal and oblique-axial views) and then using a combination of MRI and axial CT. Tumors were classified as rectal/rectosigmoid/sigmoid (according to published STO definitions) and then dichotomized into rectal versus sigmoid. Diagnostic confidence was documented using a 5-point scale.
RESULTS RESULTS
Adding CT resulted in a change in anatomical tumor classification in 4/40 cases (10%) for the junior reader and in 6/40 cases (15%) for the senior reader. Diagnostic confidence increased significantly after adding CT for the junior reader (mean score 3.85 vs. 4.27;
CONCLUSION CONCLUSIONS
Availability of a consistent axial imaging plane - in the case of this study provided by CT - in addition to a standard MRI protocol with sagittal and oblique-axial imaging views can be helpful to more confidently localize tumors using the STO as a landmark, especially for more junior readers.

Identifiants

pubmed: 35404168
doi: 10.1177/02841851221091209
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

467-472

Auteurs

Nino Bogveradze (N)

Department of Radiology, 1228The Netherlands Cancer Institute, Amsterdam, The Netherlands.
GROW School for Oncology & Developmental Biology, 5211University of Maastricht, Maastricht, The Netherlands.
Department of Radiology, American Hospital Tbilisi, Tbilisi, Georgia.

Monique Maas (M)

Department of Radiology, 1228The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Najim El Khababi (N)

Department of Radiology, 1228The Netherlands Cancer Institute, Amsterdam, The Netherlands.
GROW School for Oncology & Developmental Biology, 5211University of Maastricht, Maastricht, The Netherlands.

Niels W Schurink (NW)

Department of Radiology, 1228The Netherlands Cancer Institute, Amsterdam, The Netherlands.
GROW School for Oncology & Developmental Biology, 5211University of Maastricht, Maastricht, The Netherlands.

Max J Lahaye (MJ)

Department of Radiology, 1228The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Frans Ch Bakers (FC)

Department of Radiology, 199236Maastricht University Medical Centre, Maastricht, The Netherlands.

Pieter J Tanis (PJ)

Department of Surgery, Amsterdam UMC, Cancer Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands.
Department of Surgical Oncology and Gastrointestinal Surgery, 6993Erasmus MC, Rotterdam, The Netherlands.

Miranda Kusters (M)

Department of Surgery, Amsterdam University Medical Centres, Cancer Centre Amsterdam, 1209University of Amsterdam and VU University, Amsterdam, The Netherlands.

Geerard L Beets (GL)

GROW School for Oncology & Developmental Biology, 5211University of Maastricht, Maastricht, The Netherlands.
Department of Surgery, 1228The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Regina Gh Beets-Tan (RG)

Department of Radiology, 1228The Netherlands Cancer Institute, Amsterdam, The Netherlands.
GROW School for Oncology & Developmental Biology, 5211University of Maastricht, Maastricht, The Netherlands.
Institute of Regional Health Research, University of Southern Denmark, Denmark.

Doenja Mj Lambregts (DM)

Department of Radiology, 1228The Netherlands Cancer Institute, Amsterdam, The Netherlands.

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