In:
Digestive Diseases, S. Karger AG, Vol. 25, No. 1 ( 2007), p. 80-85
Abstract:
〈 i 〉 Purpose: 〈 /i 〉 To determine the accuracy of conventional computed tomography (CT) scan in the preoperative prediction of an involved circumferential resection margin (CRM) in primary rectal cancer. 〈 i 〉 Methods: 〈 /i 〉 125 patients with biopsy-proven adenocarcinoma of the rectum underwent CT of the abdomen before undergoing total mesorectal excision. Scans were scored by three observers, differing in experience. The main outcome was yes/no involvement of the CRM. Histology was taken as reference standard. 〈 i 〉 Results: 〈 /i 〉 For the most experienced observer, observer A, sensitivity was 46.7% and specificity 92.6%. For observer B, sensitivity was 46.7% and specificity 89.5%. For the least experienced observer C, sensitivity was 43.3% and specificity 92.6%. Inter-observer variability was good between observers A and B (ĸ 0.648), B and C (ĸ 0.648), and intermediate between A and C (ĸ 0.542). Discrepancies occurred in a total of 34 patients; 25 had a CT scan of low technical quality, 10 an anteriorly located distal tumor. 〈 i 〉 Conclusion: 〈 /i 〉 Conventional CT scan lacks sensitivity for a clinical use in the preoperative assessment of an involved CRM in primary rectal cancer. Modern multislice spiral CT will probably resolve some of the problems of conventional CT; however, further research is needed to establish its role.
Type of Medium:
Online Resource
ISSN:
0257-2753
,
1421-9875
Language:
English
Publisher:
S. Karger AG
Publication Date:
2007
detail.hit.zdb_id:
1482221-0
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