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Radiation Medicine

, Volume 26, Issue 1, pp 6–14 | Cite as

Computed tomographic air-contrast enema imaging for presurgical examination of colon tumors: assessment with colon phantoms and in patients

  • Yasuyo KayashimaEmail author
  • Fumiko Kimura
  • Kaiji Inoue
  • Yukiko Honda
  • Tadashi Nakanishi
  • Katsuhide Ito
Original Article

Abstract

Purpose

We investigated the mechanism of colon wall deformities in phantoms and assessed the relation between pathological T staging and wall deformity in patients using computed tomography (CT) enema imaging.

Materials and Methods

We performed multidetector-row CT in mass-containing phantoms with no structural deformities and in 36 patients with colon tumors. In the phantoms, we compared images on double-contrast barium (DCB) and CT enema studies, and we compared wall deformities on CT enema studies and the actual phantom structure. In patients, we compared wall deformities on CT enema studies and T staging.

Results

Images from CT enema and DCB studies were identical in the phantom, and all profile images showed geometrical basal indentations. In patients, the grade of deformity increased with invasion depth; and the diagnostic accuracy of T staging was 82.5%. Geometrical basal indentation and poor colon expansion were the primary reasons for overestimating T staging on CT enema imaging.

Conclusion

Although CT enema imaging allows reasonable diagnostic accuracy of T staging, wall deformity is thought to be consistent with tumor infiltration and other factors. We recommend evaluating T staging using not only CT enema imaging but also other techniques, such as virtual endoscopy, axial imaging, and multiplanar reformation imaging.

Key words

Colon tumor CT enema Phantom study T staging 

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References

  1. 1.
    Fenlon HM, Nunes DP, Schroy PC 3rd, Barish MA, Clarke PD, Ferrucci JT. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med 1999;341:1496–1503.PubMedCrossRefGoogle Scholar
  2. 2.
    Fidler JL, Johnson CD, MacCarty RL, Welch TJ, Hara AK, Harmsen WS. Detection of flat lesions in the colon with CT colonography. Abdom Imaging 2002;27:292–300.PubMedGoogle Scholar
  3. 3.
    Gollub MJ. Virtual colonoscopy. Lancet 2002;360:964.PubMedCrossRefGoogle Scholar
  4. 4.
    Gluecker TM, Fletcher JG. CT colonography (virtual colonoscopy) for the detection of colorectal polyps and neoplasms: current status and future developments. Eur J Cancer 2002;38:2070–2078.PubMedCrossRefGoogle Scholar
  5. 5.
    Pescatore P, Glucker T, Delarive J, Meuli R, Pantoflickova D, Duvoisin B, et al. Diagnostic accuracy and interobserver agreement of CT colonography (virtual colonoscopy). Gut 2000;47:126–130.PubMedCrossRefGoogle Scholar
  6. 6.
    Summers RM, Johnson CD, Pusanik LM, Malley JD, Youssef AM, Reed JE. Automated polyp detection at CT colonography: feasibility assessment in a human population. Radiology 2001;219:51–59.PubMedGoogle Scholar
  7. 7.
    McMahon PM, Gazelle GS. Colorectal cancer screening issues: a role for CT colonography? Abdom Imaging 2002;27:235–243.PubMedGoogle Scholar
  8. 8.
    Klingenbeck-Regn K, Schaller S, Flohr T, Ohnesorge B, Kopp AF, Baum U. Subsecond multi-slice computed tomography: basics and applications. Eur J Radiol 1999;31:110–124.PubMedCrossRefGoogle Scholar
  9. 9.
    Ushio K, Ishikawa T, Sasagawa M, Yamada T, Itabashi M, Hirota E, et al. Roentgenographic diagnosis on depth of invasion in colorectal cancer. Dig Surg 1983;6:1474–1493.Google Scholar
  10. 10.
    Ushio K, Goto H, Muramatsu Y, Takayasu K, Moriyama N, Matsue H, et al. Significance of profile view in the X-ray diagnosis of cancer the digestive tract-diagnosis of depth of invasion by double contrast study. Stomach Intestine 1986;21:27–41.Google Scholar
  11. 11.
    Maruyama M. [Radiological diagnosis of polyps and carcinoma of the large bowel.] Rinsho Hoshasen [Clin Radiol] 1980;25:709–716 (Japanese).Google Scholar
  12. 12.
    Welin S, Youker J, Spratt JS Jr. The rates and patterns of growth of 375 tumors of the large intestine and rectum observed serially by double contrast barium study (Malmoe technique). Am J Roentgenol Radium Ther Nucl Med 1963;90:673–687.PubMedGoogle Scholar
  13. 13.
    Filippone A, Ambrosini R, Fuschi M, Marinelli T, Genovesi D, Bonomo L. Preoperative T and N staging of colorectal cancer: accuracy of contrast-enhanced multi-detector row CT colonography—initial experience. Radiology 2004;231:83–90.PubMedCrossRefGoogle Scholar
  14. 14.
    Iannaccone R, Laghi A, Passariello R. Colorectal carcinoma: detection and staging with multislice CT (MSCT) colonography. Abdom Imaging 2005;30:13–19.PubMedCrossRefGoogle Scholar
  15. 15.
    Nagata K, Endo S, Kudo SE, Kitanosono T, Kushihashi T. CT air-contrast enema as a preoperative examination for colorectal cancer. Dig Surg 2004;21:352–358.PubMedCrossRefGoogle Scholar
  16. 16.
    Ament AE, Alfidi RJ, Rao PS. Basal indentation of sessile polypoid lesions: a function of geometry rather than a sign of malignancy. Radiology 1982;143:341–344.PubMedGoogle Scholar
  17. 17.
    Sato T, Sakai Y, Mitani H, Kadowaki K, Narumi Y, Kuriyama K, et al. [Radio-geometric considetation of basal indentation using phantoms and specimens.] Rinsho Hoshasen [Clin Radiol] 1989;34:1555–1561 (Japanese).Google Scholar

Copyright information

© Japan Radiological Society 2008

Authors and Affiliations

  • Yasuyo Kayashima
    • 1
    Email author
  • Fumiko Kimura
    • 1
  • Kaiji Inoue
    • 1
  • Yukiko Honda
    • 2
  • Tadashi Nakanishi
    • 3
  • Katsuhide Ito
    • 4
  1. 1.Department of RadiologySaitama Medical University International Medical CenterHidakaJapan
  2. 2.Department of RadiologyChugoku Rousai HospitalKureJapan
  3. 3.Department of RadiologyKurashiki Central HospitalKurashikiJapan
  4. 4.Department of RadiologyHiroshima University HospitalHiroshimaJapan

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