Skip to main content

Advertisement

SpringerLink
Log in

Three-Dimensional Anal Endosonography May Improve Staging of Anal Cancer Compared With Two-Dimensional Endosonography

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

PURPOSE

Three-dimensional (3-D) endosonography is a new method of staging anal carcinoma that has not yet been validated in comparison with two-dimensional (2-D) endosonography, the latter using only a single scan plane. The aim of this study was to investigate the differences between the two endosonographic techniques.

METHODS

Thirty patients with an endosonographically detectable anal tumor were examined with a 10 MHz rotating endoprobe. Cross-sectional images of the anal sphincters were stored on a 3-D system during retraction of the endoprobe through the anal canal. Afterwards, any projection could be reconstructed. Cross-sectional images (2-D) were compared with reconstructed projections (3-D) according to five parameters concerning tumor spread and presence of regional lymph nodes. In this study, a scale of 0 to 5 points on critical issues was used; ideally, the results should be identical in 2-D and 3-D endosonography.

RESULTS

The 3-D method detected a median of 5 diagnostic findings, compared with a median of 4 findings with the 2-D method (P = 0.001). In eight patients the lateral tumor margin was visualized only by 3-D endosonography. The median number of lymph nodes visualized in 3-D was 1 (range, 0-13), in 2-D the median number was 0 (range, 0-6), P = 0.002.

CONCLUSIONS

Use of 3-D endosonography in patients with anal carcinoma improves detection of perirectal lymph nodes and may improve that of tumor invasion, compared with 2-D endosonography. This may affect local tumor staging and thus planning of treatment. A study with histopathologic correlation is needed to verify this endosonographic study.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.

Similar content being viewed by others

References

  1. M Giovanni VJ Bardou R Barclay et al. (2001) ArticleTitleAnal carcinoma: prognostic value of endorectal ultrasound (ERUS). Results of a prospective multi center study Endoscopy 33 231–6

    Google Scholar 

  2. B Magdeburg M Fried C Meyenberger (1999) ArticleTitleEndoscopic ultrasonography in the diagnosis, staging, and follow-up of anal carcinomas Endoscopy 31 359–64

    Google Scholar 

  3. A Maier SH Krezner F Herbst et al. (2000) ArticleTitleTransrectal sonography of anal sphincter infiltration in lower rectal carcinoma AJR Am J Roentgenol 175 735–9

    Google Scholar 

  4. G Roseau L Palazzo P Colardelle S Chaussade D Couturier JA Paozaggi (1994) ArticleTitleEndoscopic ultrasonography in the staging and follow-up of epidermoid carcinoma of the anal canal Gastrointest Endoscopy 40 447–50

    Google Scholar 

  5. U Herzog M Boss HP Spichtin (1994) ArticleTitleEndoanal ultrasonography in the follow-up of anal carcinoma Surg Endosc 8 1186–9

    Google Scholar 

  6. JR Miro S Benjamin K Binmoeller et al. (1993) ArticleTitleClinical applications of endoscopic ultrasonography in gastroenterology Endoscopy 25 358–66

    Google Scholar 

  7. AH Sultan RA Nicholls MA Kamm (1993) ArticleTitleAnal endosonography and correlation with in vitro and in vivo anatomy Br J Surg 80 508–11

    Google Scholar 

  8. M Lohnert JM Doniec G Kovacs J Schroeder P Dohrmann (1998) ArticleTitleNew method of radiotherapy for anal cancer with three-dimensional tumor reconstruction based on endoanal ultrasound and ultrasound-guided afterloading therapy Dis Colon Rectum 41 169–76

    Google Scholar 

  9. AB Williams CI Bartram S Halligan MM Marshall RJ Nichols WA Kmiot (2002) ArticleTitleEndosonographic anatomy of the normal anal canal compared with endocoil magnetic resonance imaging Dis Colon Rectum 45 176–83

    Google Scholar 

  10. DM Gold CI Bartram S Halligan KN Humphries MA Kamm NA Kmiot (1999) ArticleTitleThree-dimensional endoanal sonography in assessing anal canal injury Br J Surg 86 365–75

    Google Scholar 

  11. MB Nielsen (1998) ArticleTitleEndosonography of the anal sphincter muscles in healthy volunteers and in patients with defecation disorders Acta Radiol Suppl 39 1–21

    Google Scholar 

  12. American Joint Committee on Cancer. AJCC Cancer Staging Manual. 5th ed. Philadelphia: Lippincott-Raven, 1997.

  13. S Goldman U Norming C Svensson B Glimelius (1991) ArticleTitleTransanorectal ultrasonography in the staging of anal epidermoid carcinoma Int J Colorect Dis 6 152–7

    Google Scholar 

  14. D Tarantino MA Bernstein (2002) ArticleTitleEndoanal ultrasound in the staging and management of squamous-cell cacinoma of the anal canal: potential implications of a new ultrasound staging system Dis Colon Rectum 45 16–22

    Google Scholar 

  15. M Claudon F Tranquart DH Evans F Lefevre JM Correas (2002) ArticleTitleAdvances in ultrasound Eur Radiol 12 7–18

    Google Scholar 

  16. E Rociu J Stoker JC Marinus MI Eiijkemanns JS Lameris (2000) ArticleTitleNormal anal sphincter anatomy and age- and sex- related variations at high-spatial-resolution MR imaging Radiol 217 395–401

    Google Scholar 

  17. RG Beets-Tan GL Beets AG Hoop Particlevan der (1999) ArticleTitleHigh- resolution magnetic resonance imaging of the anorectal region without an endocoil Abdom Imaging 24 576–84

    Google Scholar 

  18. DR Radin (1994) ArticleTitleSquamous cell carcinoma of the anus and rectum in homosexual men: CT findings J Comput Assist Tomogr 18 921–4

    Google Scholar 

  19. M Indinnimeo C Cicchini AA Stazi C Ghini P Mingazzini A Laghi (2001) ArticleTitleAnalysis of a follow-up programme for anal carcinoma J Exp Clin Cancer Res 20 199–203

    Google Scholar 

  20. H Roed SA Engelholm LB Svendsen F Rosendal KJ Olsen (1996) ArticleTitlePulsed dose rate (PDR) brachytherapy of anal carcinoma Radiother Oncol 41 131–4

    Google Scholar 

  21. MB Nielsen S Qvitzau JF Pedersen (1993) ArticleTitleDetection of pericolonic lymph nodes in patients with colorectal cancer: An in vitro and in vivo study of the efficacy of endosonography AJR Am J Roentgenol 161 57–60

    Google Scholar 

  22. M Hunerbein PM Schlag (1997) ArticleTitleThree-dimensional endosonography for staging of rectal cancer Ann Surg 225 432–8

    Google Scholar 

  23. A Calleja Jlm Albillos (1998) ArticleTitleThree.dimensional endosonography for staging of rectal cancer Gastrointest Endost 47 317–8

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Section of Ultrasound X4123, Rigshospitalet, Copenhagen, Denmark

    Anders F. Christensen M.D. & Michael B. Nielsen M.D., D.M.Sc.

  2. Department of Oncology, Rigshospitalet, Copenhagen, Denmark

    Svend A. Engelholm M.D., D.M.Sc. & Henrik Roed M.D., D.M.Sc.

  3. Department of Surgery C, Rigshospitalet, Copenhagen, Denmark

    Lars B. Svendsen M.D., D.M.Sc.

  4. Department of Neurology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark

    Hanne Christensen M.D., Ph.D.

Authors
  1. Anders F. Christensen M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael B. Nielsen M.D., D.M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Svend A. Engelholm M.D., D.M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Henrik Roed M.D., D.M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lars B. Svendsen M.D., D.M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hanne Christensen M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anders F. Christensen M.D..

Additional information

Supported by grants from Mogens Andreasen Fonden and Ragnhild Ibsens Legat for Medicinsk Forskning.

About this article

Cite this article

Christensen, A., Nielsen, M., Engelholm, S. et al. Three-Dimensional Anal Endosonography May Improve Staging of Anal Cancer Compared With Two-Dimensional Endosonography. Dis Colon Rectum 47, 341–345 (2004). https://doi.org/10.1007/s10350-003-0056-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-003-0056-z

Key words

Search

Navigation