ABSTRACT

OBJECTIVE:

Fort he selection of rectal cancer patients to neoadjuvant chemoraditherapy the most important step is the preoperative staging which should lessen the risks of over and undertreatment by under and over staging. In this study we compared the staging efficacy of endorectal ultrasound (ERUS) and endorectal magnetic resonance imaging (ERMRI) in order to find the prefered modality for preoperative rectal cancer staging.

METHODS:

Fourteen patients diagnosed to have rectal cancer verified by endoscopic biopsies between March 2003 and April 2004 were included in this study. All patients underwent surgery following their preoperative staging by the usage of both ERMRI and ERUS. The preoperative radiological stages of these patients detected by ERMRI and ERUS were compared to postoperative pathological stages.

RESULTS:

In our study, it has been shown that the detailed structure of the rectal wall layers can be imaged with both ERMRI and ERUS and that there’s no significant difference between these two methods for determining the accurate T stages in all patients. In consideration of the T stages, the estimated accuracy rate of ERMRI was 57% and of ERUS to be 64%. On the other hand for the N stages ERMRI was calculated to be 71.4% and ERUS to be 85% accurate when compared. It was also found out that for diagnosing the full thicknes rectal wall invasion tumors, which is the most important parameter for the T staging of rectal cancer, ERUS had superior accuracy than ERMRI as a diagnostic tool.

CONCLUSION:

As the conclusion of this study it can be stated that; being an easier method to perform and a more convenient procedure in means of patient comfort and adaptation, ERUS is trustworthy to be used alone for the preoperative staging of rectal cancer and it’s also sufficient enough for making the decision of neoadjuvant therapy as well, apart from other preoperative diagnostic tools.