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

Radiation Medicine volume 26, pages 6–14 (2008)Cite this 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.

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Authors and Affiliations

  1. Department of Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-1298, Japan

    Yasuyo Kayashima, Fumiko Kimura & Kaiji Inoue

  2. Department of Radiology, Chugoku Rousai Hospital, Kure, Japan

    Yukiko Honda

  3. Department of Radiology, Kurashiki Central Hospital, Kurashiki, Japan

    Tadashi Nakanishi

  4. Department of Radiology, Hiroshima University Hospital, Hiroshima, Japan

    Katsuhide Ito

Authors
  1. Yasuyo Kayashima
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  2. Fumiko Kimura
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  3. Kaiji Inoue
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  4. Yukiko Honda
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  5. Tadashi Nakanishi
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  6. Katsuhide Ito
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Correspondence to Yasuyo Kayashima.

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Kayashima, Y., Kimura, F., Inoue, K. et al. Computed tomographic air-contrast enema imaging for presurgical examination of colon tumors: assessment with colon phantoms and in patients. Radiat Med 26, 6–14 (2008). https://doi.org/10.1007/s11604-007-0185-8

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  • DOI: https://doi.org/10.1007/s11604-007-0185-8

Key words

  • Colon tumor
  • CT enema
  • Phantom study
  • T staging