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Verbesserte Rezidiverkennbarkeit mittels multiplanarer Rekonstruktion beim Rektumkarzinom in der Mehrzeilenspiralcomputertomographie

Improvements in detection of rectal cancer recurrence by multiplanar reconstruction

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Zusammenfassung

Fragestellung

Ermöglicht der Einsatz der Mehrzeilencomputertomographie (MS-CT) mit den damit verbundenen Möglichkeiten der multiplanaren Rekonstruktion eine bessere Rezidiverkennbarkeit beim operierten und bestrahlten Rektumkarzinom als die dünnschichtige axiale Rekonstruktion?

Methodik

In die Arbeit eingeschlossen wurden 83 Patienten, die nach Operation und Bestrahlung eines Rektumkarzinoms mittels MS-CT nachuntersucht wurden. Insgesamt 294 CT-Untersuchungen wurden jeweils in einer Schichtdicke von 8, 5 und 1,25 mm in axialer Schichtorientierung und in multiplanaren Rekonstruktionen von 2 Radiologen auf das Vorliegen eines Rezidivs beurteilt. Es wurden für die jeweilige Untersuchung die Sensitivität, Spezifität, Genauigkeit und der positive Vorhersagewert berechnet.

Ergebnisse

Die multiplanare Schichtführung zeigt zu allen Untersuchungszeitpunkten bessere Ergebnisse als die axiale. Durch eine dünnschichtigere Rekonstruktion der axialen Schichten ließ sich keine signifikante Verbesserung in der Rezidivdiagnostik erzielen. Für die multiplanare Rekonstruktion errechnet sich eine Sensitivität von 0,88, eine Spezifität von 0,98, eine Genauigkeit von 0,96 und ein positiver Vorhersagewert von 0,94. Für die axiale Rekonstruktion ergeben sich entsprechend: 0,82, 0,97, 0,94 und 0,88. Die Sensitivität und Genauigkeit beider Schichtführungen zeigen einen signifikanten Anstieg von der 1. zur 2. CT-Untersuchung sowie einen weiteren Anstieg zur 3. Nachuntersuchung.

Schlussfolgerungen

Durch die Anwendung multiplanarer Rekonstruktionen ist eine signifikante Verbesserung der Rezidiverkennbarkeit beim Rektumkarzinom möglich. Eine geringere axiale Schichtdicke führt zu keiner signifikanten Verbesserung der Rezidivdiagnostik.

Abstract

Purpose

To evaluate the advantages of multiplanar reconstruction and different axial slice thickness in diagnostic of rectal cancer recurrence after operation and radiotherapy.

Method

We included 83 patients after operation and radiotherapy of rectal cancer in this study. All patients got a minimum of three CT-examinations in their follow-up program. A total of 294 CT-scans were evaluated. Each examination was reviewed by two experienced radiologists in respect to recurrence. Each examination was presented in axial reconstruction with a slice sickness of 8, 5, and 1,25 mm and in multiplanar reconstruction. The sensitivity, specifity, positive predictive value and accuracy were calculated.

Results

Multiplanar reconstructions showed better results for the detection of recurrence than axial reconstruction. A reduced slice thickness did not lead to better results in axial reconstruction. Multiplanar reconstruction showed a sensitivity of 0,88, a specifity of 0,98, an accuracy of 0,96 and a positive predictive value of 0,94, for axial reconstruction we calculated: 0,82, 0,97, 0,94 and 0,88, respectively. Sensitivity and accuracy showed a significant increase after the first and second examination.

Conclusion

Multiplanar reconstructions allow a significant better detection of rectal cancer recurrence when compared to axial reconstructions. Thinner axial slice thickness shows no diagnostic advantage.

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Author information

Authors and Affiliations

  1. Klinik für Radiologische Diagnostik und Nuklearmedizin, Marienhospital Herne

    C. A. Stückle, M. Jendreck, R. Kickuth & D. Liermann

  2. Medizinische Klinik I, Marienhospital Herne

    K. F. Haegele

  3. Klinik für Strahlentherapie und Radioonkologie, Marienhospital Herne

    O. Schneider

  4. Chirurgische Klinik, Marienhospital Herne

    G. Hohlbach

  5. Klinik für Radiologische Diagnostik und Nuklearmedizin, Marienhospital Herne, Hölkeskampring 40, 44625 , Herne

    C. A. Stückle

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  1. C. A. Stückle
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  3. M. Jendreck
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  4. R. Kickuth
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Correspondence to C. A. Stückle.

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Stückle, C.A., Haegele, K.F., Jendreck, M. et al. Verbesserte Rezidiverkennbarkeit mittels multiplanarer Rekonstruktion beim Rektumkarzinom in der Mehrzeilenspiralcomputertomographie. Radiologe 45, 930–936 (2005). https://doi.org/10.1007/s00117-003-0950-3

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