Preoperative staging of rectal cancer: accuracy of 3-Tesla magnetic resonance imaging

The purpose of this study was to evaluate the accuracy of 3-Tesla magnetic resonance imaging (MRI) for the preoperative staging of rectal cancer. Thirty-five patients with a primary rectal cancer who underwent preoperative 3-T MRI using a phased-array coil and had a surgical resection were enrolled in the study group. Preoperatively, three experienced radiologists independently assessed the T and N staging. A confidence level scoring system was used to determine if there was any perirectal invasion, and receiver operating characteristic (ROC) curves were generated. The interobserver agreement was estimated using kappa statistics. The overall accuracy rate of T staging for rectal cancer was 92%. The diagnostic accuracy was 97% for T1, 89% for T2 and 91% for T3, respectively. The predictive accuracy for perirectal invasion by the three observers was high (Az > 0.92). The interobserver agreement for T staging was moderate to substantial. The overall sensitivity, specificity, and accuracy for the detection of mesorectal nodal metastases were 80%, 98%, and 95%, respectively. In conclusion, preoperative 3-T MRI using a phase-array coil accurately indicates the depth of tumor invasion for rectal cancer with a low variability.