4.4 Article

Preoperative evaluation of pelvic lateral lymph node of patients with lower rectal cancer: comparison study of MR imaging and CT in 53 patients

Journal

LANGENBECKS ARCHIVES OF SURGERY
Volume 391, Issue 5, Pages 449-454

Publisher

SPRINGER
DOI: 10.1007/s00423-006-0066-0

Keywords

lower rectal cancer; lateral pelvic lymph node involvement; spiral computed tomography; magnetic resonance imaging

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Background Preoperative assessment of the lateral pelvic lymph nodes is important for treatment strategy to patients with lower rectal cancer. Materials and methods Fifty-three patients with primary lower rectal cancer were preoperatively assessed by spiral computed tomography (CT) and magnetic resonance imaging (MRI) at 1.5 T with a phased-array coil. Preoperative tumor and lymph node stages were compared with the final histological findings. Results The MRI tumor stage coincided with the histological stage in 36 of 53 patients (68%). The MRI and CT lymph node stage coincided with the histological stage in 33 (62%) and 26 (49%) of 53 patients, respectively. However the accuracy of MRI in detecting the lateral pelvic lymph node involvement was 83%, compared to 77% of CT (p < 0.05). Conclusions With the use of MRI, the lateral pelvic lymph node involvement can be predicted with high accuracy, allowing preoperative identification of patients who need radiotherapy or extensive surgery to escape recurrence.

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