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Preoperative T Staging of Colorectal Cancer by CT Colonography

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

This study was designed to estimate the accuracy of CT colonography for the assessment of T stage in colorectal cancer.

Methods

CT colonograms obtained from 246 lesions were reviewed by 3 investigators. Intestinal wall deformity on shaded-surface display and rough appearance around the intestine were studied to assess their relations to T stage. Intestinal wall deformity was classified into arc type, trapezoid type, and apple-core type, defined as a trapezoidal wall deformity involving ≥50 percent of the circumference of the lumen.

Results

As for intestinal wall deformity, the rate of arc type was higher in Tis/T1 than in T2 (74 percent: 17/23 vs. 24 percent: 8/34, P < 0.0001); the rate of trapezoid type was 17 percent (4/23) in Tis/T1, 59 percent (20/34) in T2, and 15 percent (28/189) in T3/T4 (Tis/T1 vs.T2, P < 0.0001; T2 vs. T3/T4, P < 0.0001); and the rate of apple-core type was lower in T2 than in T3/T4 (18 percent: 6/34 vs. 81 percent: 154/189, P < 0.0001). Arc type, trapezoid type, and apple-core type were primarily associated with T1, T2, and T3/T4, respectively. When these criteria were used, the overall accuracy for T stage was 79 percent. Rough appearance was specific for T3/T4, but insensitive.

Conclusions

CT colonography can provide important information for the preoperative assessment of T stage in colorectal cancer.

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Authors and Affiliations

  1. Department of Radiology, Jichi Medical University, Shimotsuke, Tochigi, Japan

    Kenichi Utano M.D. & Hideharu Sugimoto M.D., Ph.D.

  2. Department of Surgery, Jichi Medical University, 3311–1 Yakushiji, Shimotsuke, Tochigi, 329–0498, Japan

    Kazuhiro Endo M.D., Kazutomo Togashi M.D., Ph.D. & Hisanaga Horie M.D., Ph.D.

  3. Department of Surgery, Omiya Medical Center, Jichi Medical University, Omiya, Saitama, Japan

    Junichi Sasaki M.D., Ph.D., Hiroshi J. Kawamura M.D., Ph.D. & Fumio Konishi M.D., Ph.D.

  4. Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan

    Yosikazu Nakamura M.D., Ph.D.

Authors
  1. Kenichi Utano M.D.
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  2. Kazuhiro Endo M.D.
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  3. Kazutomo Togashi M.D., Ph.D.
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  4. Junichi Sasaki M.D., Ph.D.
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  5. Hiroshi J. Kawamura M.D., Ph.D.
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  6. Hisanaga Horie M.D., Ph.D.
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  7. Yosikazu Nakamura M.D., Ph.D.
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  8. Fumio Konishi M.D., Ph.D.
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  9. Hideharu Sugimoto M.D., Ph.D.
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Corresponding author

Correspondence to Kazutomo Togashi M.D., Ph.D..

Additional information

Presented at the meeting of United European Gastroenterology, Berlin, Germany, October 21 to 25, 2006.

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Utano, K., Endo, K., Togashi, K. et al. Preoperative T Staging of Colorectal Cancer by CT Colonography. Dis Colon Rectum 51, 875–881 (2008). https://doi.org/10.1007/s10350-008-9261-0

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  • DOI: https://doi.org/10.1007/s10350-008-9261-0

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