Skip to main content
SpringerLink
Log in

Endoscopic Ultrasound for Staging Rectal and Anal Cancer

  • Chapter
Book cover Endoscopic Oncology

  • 903 Accesses

Abstract

Rectal endoscopic ultrasound (RUS) has proven very beneficial in the staging of malignant neoplasm in the anus and rectum (1,2). Typically, imaging is performed using an adult standard radial ultrasound endoscope, commonly used in evaluation of the upper gastrointestinal tract (3). Based on RUS, the normal rectal wall architecture consists of a mucosal layer (muscularis mucosa and lamina propria—also referred to as superficial and deep layers), submucosa, muscularis propria, and surrounding perirectal fat tissue without a serosa/adventiaa layer (2). Carcinoma appears as a hypoechoic mass lesion with partial or total destruction of the normal wall layer. RUS has also been useful in examining for tumor invasion in the surrounding regional organs: which in males would include evaluating the bladder, seminal vesicles, prostate, and internal anal sphincters (IASs)/external anal sphincters (EASs); and in females would include evaluation of the bladder, uterus/vagina, and IASs/EASs (2,2). Moreover, RUS is very helpful in evaluation of malignant lymphadenopathy. All of these features are useful in the pre-operative staging of rectal and anal carcinomas (1,2).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Schwartz DA, Harewood GC, Wiersema MJ. EUS for rectal disease—review article. Gastrointest Endosc 2002; 56(1): 100–109.

    Article  PubMed  Google Scholar 

  2. Gopal DV, Faigel DO. Rectal endoscopic ultrasound—a review of clinical applications. Practical Gastroenterol 2000; XXIV(12):24–34.

    Google Scholar 

  3. Bhutani M, Nadella P. Utility of an upper echoendoscope for endoscopic ultrasonography of malignant and benign conditions of the sigmoid/left colon and rectum. Am J Gastroenterol 2001; 96:3318–3322.

    Article  PubMed  CAS  Google Scholar 

  4. Baum AE. Overview of rectal cancer. The Resident Reporter 2001; 6(10):27–35.

    Google Scholar 

  5. Savides TJ, Hawes RH. Endoscopic ultrasound staging of rectal cancer. In Gastrointestinal Endosonography. Vandam & Sivak: WB Saunders; 1999:279–289.

    Google Scholar 

  6. Meyenberger C, Huch Boni RA, Bertschinger P, Zala GF, Klotz HP, Krestin GP. Endoscopic ultrasound and endorectal magnetic resonance imaging: a prospective, comparative study for preoperative staging and follow-up of rectal cancer. Endoscopy 1995; 27:469–479.

    Article  PubMed  CAS  Google Scholar 

  7. Waizer A, Powsner B, Russo I, et al. Prospective comparative study of magnetic resonance imaging versus transrectal ultrasound for preoperative staging and follow-up of rectal cancer. Preliminary report. Dis Colon Rectum 1990; 33:863–868.

    Article  Google Scholar 

  8. Bhutani MS. Colorectal Endoscopic Ultrasonography. In: Gress FG and Bhattacharya I. Endoscopic Ultrasonography. Blackwell Science Inc. 2001: 126–135.

    Google Scholar 

  9. Rosch T, Classen M. Endosonography of the Colon and Rectum-Normal Anatomy using the Radial Scanning Echoendoscope. Gastrointestinal Endosonography. Vandam & Sivak. WB Saunders. 1999; (27):271–277.

    Google Scholar 

  10. Frudinger A, Bartrum CI, Halligan S, Kamm M. Examination techniques for endosonography of the anal canal. Abdominal Imaging 1998; 23:301–303.

    Article  PubMed  CAS  Google Scholar 

  11. Parmar KS, Fleming D, Waxman I. The Clinical impact of Endoscopic Ultrasound guided Fine Needle Aspiration in the Management of Colorectal Carcinoma. Gastrointest Endosc. 2000: Abstract#4572: AB 171.

    Google Scholar 

  12. Woodward T, Menke D. Diagnosis of recurrent rectal carcinoma by EUS-guided fine-needle aspiration. Gastrointest Endosc 2000; 51:223–225.

    Article  PubMed  CAS  Google Scholar 

  13. Colon and Rectum. American Joint Committee on Cancer. Manual for Staging of Cancer, 4th ed. Philadelphia: JB Lippincott; 1992:75–79.

    Google Scholar 

  14. Hawes RH. New Staging Techniques. Cancer (supplement) 1993; 71(12):4207–4213.

    Article  CAS  Google Scholar 

  15. Harewood GC, Kumar KS, Clain JE, Levy MJ, Nelson H. Clinical implications of quantification of mesorectal tumor invasion by endoscopic ultrasound: All T3 rectal cancers are not equal. J Gastroenterol Hepatol. 2004; 19(7):750–755.

    Article  PubMed  Google Scholar 

  16. Park HH, Nguyen PT, Tran Q, Chang KJ. Endoscopic ultrasound-guided fine needle aspiration in the staging of rectal cancer. Gastrointest Endosc 2000: Abstract No. 4572:AB171.

    Google Scholar 

  17. Shami VM, Parmar KS, Waxman I. Clinical impact of endoscopic ultrasound and endoscopic ultrasound-guided fine-needle aspiration in the management of rectal carcinoma. Dis Colon Rectum 2004; 47(1):59–65.

    Article  PubMed  Google Scholar 

  18. Winde G, Nottberg H, Keller R, Schmid KW, Bunte H. Surgical cure for early rectal carcinomas (T1). Transanal endoscopic microsurgery vs anterior resection. Dis Colon Rectum 1996; 39(9): 969–976.

    Article  PubMed  CAS  Google Scholar 

  19. Harewood GC. Assessment of clinical impact of endoscopic ultrasound on rectal cancer. Am J Gastroenterol 2004; 99(4):623–627.

    Article  PubMed  Google Scholar 

  20. Swedish Rectal Cancer Trial. Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 1997; 336:980–987.

    Article  Google Scholar 

  21. Lin DE, Vanagunas A, Stryker S. Endoscopic ultrasound restaging of rectal caner is inaccurate following neoadjuvant chemo-radiation therapy. Gastrointest Endosc 2000: Abstract No. 4574: AB172.

    Google Scholar 

  22. Vanagunas A, Lin DE, Stryker SJ. Accuracy of endoscopic ultrasound for restaging rectal cancer following neoadjuvant chemoradiation therapy. Am J Gastroenterol. 2004; 99(1):109–112.

    Article  PubMed  Google Scholar 

  23. Lohnert MS, Doniec JM, Henne-Bruns D. Effectiveness of endoluminal sonography in the identification of occult local rectal cancer recurrences. Dis Colon Rectum 2000; 43(4):483–491.

    Article  PubMed  CAS  Google Scholar 

  24. Hernandez de Anda E, Lee S-H, Finne CO, Rothenberger DA, Madoff RD, Garcia-Aguilar J. Endorectal Ultrasound in the Follow-up of Rectal Cancer Patients treated by local excision or radical surgery. Dis Colon Rectum 2004; 47:818–824.

    Article  Google Scholar 

  25. Magdeburg B, Fried M, Meyenberger C. Endoscopic ultrasonographyin the diagnosis, staging and follow-up of anal carcinomas. Endoscopy 1999; 31(5):359–364.

    Article  PubMed  CAS  Google Scholar 

  26. Lund JA, Sundstrom SH, Haaverstad R, Wibe A, Svinsaas M, Myrvold HE. Endoanal Ultrasound is of Little Value in follow-up of Anal Carcinomas. Dis Colon Rectum 2004; 47:839–842.

    Article  PubMed  Google Scholar 

  27. Hunerbein M, Totkas S, Moesta KT, Ulmer C, Handke T, Shlag PM. The role of transrectal ultrasound-guided biopsy in the postoperative follow-up of patients with rectal cancer. Surgery 2001; 129:164–169.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Gastroenterology and Hepatology, University of Wisconsin School of Medicine, Madison, WI

    Deepak V. Gopal MD, FRCP(C), FRCP (Assistant Professor of Medicine)

Authors
  1. Deepak V. Gopal MD, FRCP(C), FRCP
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Oregon Health and Science University, Portland, OR

    Douglas O. Faigel MD, FACG, FASGE (Associate Professor of Medicine, Director of Endoscopy) (Associate Professor of Medicine, Director of Endoscopy)

  2. Hospital of the University of Pennsylvania, Philadelphia, PA

    Michael L. Kochman MD, FACP, FASGE (Professor of Medicine and Surgery, Co-Director Gastrointestinal Oncology) (Professor of Medicine and Surgery, Co-Director Gastrointestinal Oncology)

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Humana Press, Totowa, NJ

About this chapter

Cite this chapter

Gopal, D.V. (2006). Endoscopic Ultrasound for Staging Rectal and Anal Cancer. In: Faigel, D.O., Kochman, M.L. (eds) Endoscopic Oncology. Humana Press. https://doi.org/10.1007/978-1-59745-172-7_20

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-172-7_20

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-532-3

  • Online ISBN: 978-1-59745-172-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation