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Computed tomographic colonography versus double-contrast barium enema for the preoperative evaluation of rectal cancer

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Abstract

Purpose

We investigated whether or not computed tomographic colonography (CTC) is a viable alternative to double-contrast barium enema (BE) for a preoperative rectal cancer evaluation.

Methods

The size and distance from the anal canal to the lower or upper tumor borders were laterally measured in 147 patients who underwent CTC and BE. Measurements were grouped into early cancer, advanced, and after chemoradiation therapy (CRT).

Results

In the early and advanced cancer groups, all lesions were visualized by BE. In contrast, 3 (7.8%) early and 8 (7.3%) advanced cases, located at the anterior wall near the anal canal, were not visualized by CTC because of liquid level formation. In the CRT group, 16 (23.5%) and 4 (5.8%) cases were not visualized by CTC and BE, respectively. The BE and CTC size measurements were similar among cohorts. However, the distance from the anal canal's superior margin tended to be longer with BE, especially in early cancer. The differences in distance from the anal canal were significantly larger in the early cancer group than in the other two groups (p = 0.0024).

Conclusion

CTC may be a viable alternative imaging modality in some cases. However, BE should be employed in anterior wall cases near the anal canal and CRT cases.

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Availability of data and materials

The data that support the findings of this study are available from the corresponding author, Shin Murai, upon reasonable request.

Code availability

Not applicable.

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Acknowledgements

This research is supported by Grants-in-Aid for Scientific Research (C: grant number; 18K07194, C: grant number; 19K09114, C: grant number; 19K09115, C: grant number; 20K09051, Challenging Research [Exploratory]: grant number; 20K21626) from Japan Society for the promotion of Science. This research is supported by the Project for Cancer Research and Therapeutic Evolution, grant number: JP 19cm0106502 from the Japan Agency for Medical Research and Development.

Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Shin Murai, Kazushige Kawai, Hirofumi Sonoda, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Hiroyuki Anzai & Soichiro Ishihara

Authors
  1. Shin Murai
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  2. Kazushige Kawai
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  3. Hirofumi Sonoda
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  4. Hiroaki Nozawa
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  5. Kazuhito Sasaki
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  6. Koji Murono
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  7. Shigenobu Emoto
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  8. Yuichiro Yokoyama
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  9. Hiroyuki Anzai
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  10. Soichiro Ishihara
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by KKK, HS, HN, KS, KM, SE, HI, YY, HA, and SI. The first draft of the manuscript was written by SM, and all authors commented on previous versions of the manuscript. All authors read and approved the final version.

Corresponding author

Correspondence to Shin Murai.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethics approval

All procedures involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the ethics committee of the University of Tokyo (No. 3252-(10)).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Patients gave their signed informed consent regarding publishing their data and photographs.

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Supplementary Information

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Online Resource 1

In CTC, the tumor was located near the anal canal and was not visualized because of liquid level formation around the anal canal. On the other hand, in BE, the tumor was visualized clearly. CTC, computed tomographic colonography; BE, barium enema (EPS 4635 KB)

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Murai, S., Kawai, K., Sonoda, H. et al. Computed tomographic colonography versus double-contrast barium enema for the preoperative evaluation of rectal cancer. Surg Today 52, 755–762 (2022). https://doi.org/10.1007/s00595-021-02411-5

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  • DOI: https://doi.org/10.1007/s00595-021-02411-5

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