Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Comparison of Imaging Modalities in the Diagnosis and Tumor Staging of Colorectal Adenocarcinoma

Author(s): Serdar Serinsöz* and Remzi Aktürk

Volume 19, Issue 6, 2023

Published on: 27 December, 2022

Article ID: e091222211823 Pages: 11

DOI: 10.2174/1573405619666221209114218

Price: $65

Abstract

Background: Colorectal cancer is a malignancy that affects the gastrointestinal tract. Clinical diagnosis has routinely been done with colonoscopy in conjunction with digital rectal and histological examinations.

Objective: We show that CT, MRI, and MRI-DWI are all effective in T-staging colorectal adenocarcinoma when compared to pathology examination. However, differences in the detection and diagnostic agreement rates between the imaging modalities for the specific T-stages were observed.

Methods: Fifty-six patients diagnosed with colorectal adenocarcinoma and underwent contrastenhanced abdominal CT, non-contrast MRI, or MRI-DWI between January 2014 and March 2020 were retrospectively examined and compared to a biopsy or postoperative pathological T-stage.

Results: The total diagnostic agreement rate for CT, MRI, and MRI-DWI were 58.93%, 76.79%, and 85.71%, respectively. T-staging was statistically and significantly different across all four stages analyzed for all imaging modalities. The T1-stage for MRI and MRI-DWI compared to pathology rates were statistically significant, whereas MRI-DWI and CT both demonstrated statistical significance for T3 and T2 stage comparison, respectively. Furthermore, a statistical and significant difference between the total stage comparison of MRI, MRI-DWI, and CT compared individually to pathology was also observed. All imaging modalities were able to statistically and significantly identify tumors based on tumor size according to the ROC analysis.

Conclusion: These data suggest that CT, MRI, and MRI-DWI can identify and aid visually in the diagnosis of adenocarcinoma colorectal cancer. MRI-DWI is more specific and sensitive in the diagnosis and staging of colorectal tumors.

Graphical Abstract

[1]
Brown G, Davies S, Williams GT, et al. Effectiveness of preoperative staging in rectal cancer: Digital rectal examination, endoluminal ultrasound or magnetic resonance imaging? Br J Cancer 2004; 91(1): 23-9.
[http://dx.doi.org/10.1038/sj.bjc.6601871] [PMID: 15188013]
[2]
Świderska M, Choromańska B, Dąbrowska E, et al. Review The diagnostics of colorectal cancer. Contemp Oncol (Pozn) 2014; 1(1): 1-6.
[http://dx.doi.org/10.5114/wo.2013.39995] [PMID: 24876814]
[3]
Horvat N, Carlos Tavares Rocha C, Clemente Oliveira B, Petkovska I, Gollub MJ. MRI of rectal cancer: Tumor staging, imaging techniques, and management. Radiographics 2019; 39(2): 367-87.
[http://dx.doi.org/10.1148/rg.2019180114] [PMID: 30768361]
[4]
Heo SH, Kim JW, Shin SS, Jeong YY, Kang H-K. Multimodal imaging evaluation in staging of rectal cancer. World J Gastroenterol 2014; 20(15): 4244-55.
[http://dx.doi.org/10.3748/wjg.v20.i15.4244] [PMID: 24764662]
[5]
Fass L. Imaging and cancer: A review. Mol Oncol 2008; 2(2): 115-52.
[http://dx.doi.org/10.1016/j.molonc.2008.04.001] [PMID: 19383333]
[6]
Joo I, Lee JM, Yoon JH. Imaging Diagnosis of Intrahepatic and Perihilar Cholangiocarcinoma: Recent Advances and Challenges. Radiology 2018; 288(1): 7-13.
[http://dx.doi.org/10.1148/radiol.2018171187] [PMID: 29869969]
[7]
Cleary JOSH, Guimarães AR. Magnetic Resonance Imaging. In: McManus LM, Mitchell RN, Eds. Pathobiology of Human Disease. San Diego: Academic Press 2014; pp. 3987-.
[http://dx.doi.org/10.1016/B978-0-12-386456-7.07609-7]
[8]
Ladd ME, Bachert P, Meyerspeer M, et al. Pros and cons of ultra-high-field MRI/MRS for human application. Prog Nucl Magn Reson Spectrosc 2018; 109: 1-50.
[http://dx.doi.org/10.1016/j.pnmrs.2018.06.001] [PMID: 30527132]
[9]
Berrington de Gonzalez A, Kim KP, Yee J. CT colonography: Perforation rates and potential radiation risks. Gastrointest Endosc Clin N Am 2010; 20(2): 279-91.
[http://dx.doi.org/10.1016/j.giec.2010.02.003] [PMID: 20451817]
[10]
Ridereau-Zins C, Pilleul F, Gandon Y, Laurent V. CT colonography: Why? When? How? Diagn Interv Imaging 2012; 93(1): 2-9.
[http://dx.doi.org/10.1016/j.diii.2011.10.003] [PMID: 22277705]
[11]
Song I, Kim SH, Lee SJ, Choi JY, Kim MJ, Rhim H. Value of diffusion-weighted imaging in the detection of viable tumour after neoadjuvant chemoradiation therapy in patients with locally advanced rectal cancer: Comparison with T2 weighted and PET/CT imaging. Br J Radiol 2012; 85(1013): 577-86.
[http://dx.doi.org/10.1259/bjr/68424021] [PMID: 21343320]
[12]
Urushihata T, Takuwa H, Takahashi M, et al. Exploring cell membrane water exchange in aquaporin-4-deficient ischemic mouse brain using diffusion-weighted MRI. Eur Radiol Exp 2021; 5(1): 44.
[http://dx.doi.org/10.1186/s41747-021-00244-y] [PMID: 34617156]
[13]
Fink KRT, Fink JR. 4 - Principles of Modern Neuroimaging. In Principles of Neurological Surgery (Fourth Edition), Ellenbogen RG; Sekhar LN; Kitchen ND; da Silva HB, Eds. Elsevier: Philadelphia 2018; pp 62-86.e2.
[14]
Messina C, Bignone R, Bruno A, et al. Diffusion-Weighted Imaging in Oncology: An Update. Cancers (Basel) 2020; 12(6): 1493.
[http://dx.doi.org/10.3390/cancers12061493] [PMID: 32521645]
[15]
Pereira NP, Curi C, Osório CABT, et al. Diffusion-weighted magnetic resonance imaging of patients with breast cancer following neoadjuvant chemotherapy provides early prediction of pathological response - a prospective study. Sci Rep 2019; 9(1): 16372.
[http://dx.doi.org/10.1038/s41598-019-52785-3] [PMID: 31705004]
[16]
Jang KM, Kim SH, Hwang J, et al. Differentiation of malignant from benign focal splenic lesions: Added value of diffusion-weighted MRI. AJR Am J Roentgenol 2014; 203(4): 803-12.
[http://dx.doi.org/10.2214/AJR.13.11914] [PMID: 25247945]
[17]
Beltran LS, Samim M, Gyftopoulos S, Bruno MT, Petchprapa CN. Does the addition of DWI to fluid-sensitive conventional MRI of the sacroiliac joints improve the diagnosis of sacroiliitis? AJR Am J Roentgenol 2018; 210(6): 1309-16.
[http://dx.doi.org/10.2214/AJR.17.18636] [PMID: 29629794]
[18]
Raman SP, Chen Y, Fishman EK. Evolution of imaging in rectal cancer: Multimodality imaging with MDCT, MRI, and PET. J Gastrointest Oncol 2015; 6(2): 172-84.
[PMID: 25830037]
[19]
Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart AK. Revised TN categorization for colon cancer based on national survival outcomes data. J Clin Oncol 2010; 28(2): 264-71.
[http://dx.doi.org/10.1200/JCO.2009.24.0952] [PMID: 19949014]
[20]
Monguzzi L, Ippolito D, Bernasconi DP, Trattenero C, Galimberti S, Sironi S. Locally advanced rectal cancer: Value of ADC mapping in prediction of tumor response to radiochemotherapy. Eur J Radiol 2013; 82(2): 234-40.
[http://dx.doi.org/10.1016/j.ejrad.2012.09.027] [PMID: 23122748]
[21]
Benson AB, Venook AP, Al-Hawary MM, et al. Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2021; 19(3): 329-59.
[http://dx.doi.org/10.6004/jnccn.2021.0012] [PMID: 33724754]
[22]
Tong GJ, Zhang GY, Liu J, et al. Comparison of the eighth version of the American Joint Committee on Cancer manual to the seventh version for colorectal cancer: A retrospective review of our data. World J Clin Oncol 2018; 9(7): 148-61.
[http://dx.doi.org/10.5306/wjco.v9.i7.148] [PMID: 30425940]
[23]
Sloothaak DAM, Sahami S, van der Zaag-Loonen HJ, et al. The prognostic value of micrometastases and isolated tumour cells in histologically negative lymph nodes of patients with colorectal cancer: A systematic review and meta-analysis. Eur J Surg Oncol 2014; 40(3): 263-9.
[http://dx.doi.org/10.1016/j.ejso.2013.12.002] [PMID: 24368050]
[24]
Yi X, Pei Q, Zhang Y, et al. MRI-Based Radiomics Predicts Tumor Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer. Front Oncol 2019; 9: 552-2.
[http://dx.doi.org/10.3389/fonc.2019.00552] [PMID: 31293979]
[25]
Wang X, Yuan M, Mi H, et al. The feasibility of differentiating colorectal cancer from normal and inflammatory thickening colon wall using CT texture analysis. Sci Rep 2020; 10(1): 6346.
[http://dx.doi.org/10.1038/s41598-020-62973-1] [PMID: 32286352]
[26]
Kelley SR, Nelson H. 75 - Cancer of the Rectum. In Abeloff's Clinical Oncology (Sixth Edition), Niederhuber JE; Armitage JO; Kastan MB; Doroshow JH; Tepper JE, Eds. Elsevier: Philadelphia 2020; pp 1281-1299.e7.
[27]
Kijima S, Sasaki T, Nagata K, Utano K, Lefor AT, Sugimoto H. Preoperative evaluation of colorectal cancer using CT colonography, MRI, and PET/CT. World J Gastroenterol 2014; 20(45): 16964-75.
[http://dx.doi.org/10.3748/wjg.v20.i45.16964] [PMID: 25493009]
[28]
Kekelidze M, D’Errico L, Pansini M, Tyndall A, Hohmann J. Colorectal cancer: Current imaging methods and future perspectives for the diagnosis, staging and therapeutic response evaluation. World J Gastroenterol 2013; 19(46): 8502-14.
[http://dx.doi.org/10.3748/wjg.v19.i46.8502] [PMID: 24379567]
[29]
Yee J, Weinstein S, Morgan T, Alore P, Aslam R. Advances in CT Colonography for Colorectal Cancer Screening and Diagnosis. J Cancer 2013; 4(3): 200-9.
[http://dx.doi.org/10.7150/jca.5858] [PMID: 23459511]
[30]
Mainenti PP, Cirillo LC, Camera L, et al. Accuracy of single phase contrast enhanced multidetector CT colonography in the preoperative staging of colo-rectal cancer. Eur J Radiol 2006; 60(3): 453-9.
[http://dx.doi.org/10.1016/j.ejrad.2006.08.001] [PMID: 16965883]
[31]
Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 2003; 349(23): 2191-200.
[http://dx.doi.org/10.1056/NEJMoa031618] [PMID: 14657426]
[32]
Flor N, Mezzanzanica M, Rigamonti P, et al. Contrast-enhanced computed tomography colonography in preoperative distinction between T1-T2 and T3-T4 staging of colon cancer. Acad Radiol 2013; 20(5): 590-5.
[http://dx.doi.org/10.1016/j.acra.2013.01.008] [PMID: 23477825]
[33]
Filippone A, Ambrosini R, Fuschi M, Marinelli T, Genovesi D, Bonomo L. Preoperative T and N staging of colorectal cancer: Accuracy of contrast-enhanced multi-detector row CT colonography--initial experience. Radiology 2004; 231(1): 83-90.
[http://dx.doi.org/10.1148/radiol.2311021152] [PMID: 14990815]
[34]
Saklani AP, Bae SU, Clayton A, Kim NK. Magnetic resonance imaging in rectal cancer: A surgeon’s perspective. World J Gastroenterol 2014; 20(8): 2030-41.
[http://dx.doi.org/10.3748/wjg.v20.i8.2030] [PMID: 24616572]
[35]
Santiago I, Figueiredo N, Parés O, Matos C. MRI of rectal cancer—relevant anatomy and staging key points. Insights Imaging 2020; 11(1): 100.
[http://dx.doi.org/10.1186/s13244-020-00890-7] [PMID: 32880782]
[36]
Kim H, Kim JH, Lim JS, et al. MRI findings of rectal submucosal tumors. Korean J Radiol 2011; 12(4): 487-98.
[http://dx.doi.org/10.3348/kjr.2011.12.4.487] [PMID: 21852910]
[37]
Shenoy-Bhangle A, Baliyan V, Kordbacheh H, Guimaraes AR, Kambadakone A. Diffusion weighted magnetic resonance imaging of liver: Principles, clinical applications and recent updates. World J Hepatol 2017; 9(26): 1081-91.
[http://dx.doi.org/10.4254/wjh.v9.i26.1081] [PMID: 28989564]
[38]
Padhani AR, Liu G, Mu-Koh D, et al. Diffusion-weighted magnetic resonance imaging as a cancer biomarker: Consensus and recommendations. Neoplasia 2009; 11(2): 102-25.
[http://dx.doi.org/10.1593/neo.81328] [PMID: 19186405]
[39]
Partridge SC, Nissan N, Rahbar H, Kitsch AE, Sigmund EE. Diffusion-weighted breast MRI: Clinical applications and emerging techniques. J Magn Reson Imaging 2017; 45(2): 337-55.
[http://dx.doi.org/10.1002/jmri.25479] [PMID: 27690173]
[40]
Schurink NW, Lambregts DMJ, Beets-Tan RGH. Diffusion-weighted imaging in rectal cancer: Current applications and future perspectives. Br J Radiol 2019; 92(1096)20180655
[http://dx.doi.org/10.1259/bjr.20180655] [PMID: 30433814]
[41]
Ichikawa T, Erturk SM, Motosugi U, et al. High-B-value diffusion-weighted MRI in colorectal cancer. AJR Am J Roentgenol 2006; 187(1): 181-4.
[http://dx.doi.org/10.2214/AJR.05.1005] [PMID: 16794174]
[42]
Sabry MS, Rady AEE, Niazi GEM, Ali SA. Role of diffusion-weighted MRI in diagnosis and post therapeutic follow-up of colorectal cancer. Egypt J Radiol Nucl Med 2021; 52(1): 180.
[http://dx.doi.org/10.1186/s43055-021-00561-7]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy