Accuracy Of ERUS?CT And MRI In Restaging After Preoperative Radiochemotherapy In Locally Advanced Rectal Cancer

Objective:The purpose of the paper was to compare the restaging results diagnosed by computed tomography?CT??transrectal ultrasound?TRUS?and magnetic resonance imaging?MRI?performed after neoadjuvant therapy with pathologic staging of neoplasm.To explore accuracy of CT?ERUS and MRI for locally advanced rectal cancer after neoadjuvant therapy in restaging.Method:From January 2014 to March 2018,the final data of 48 patients with locally advanced rectal cancer that underwent neoadjuvant therapy and operate total mesorectal excision radical surgery in the First Affiliated Hospital of Guangxi Medical University.The results of radiological examinations diagnosed by ERUS?CT?MRI and the definitive pathological stage were compared with each other.We can analyze the diagnostic Accuracy of ERUS?CT and MRI obtained after Neoadjuvant Chemoradiotherapy in predicting the Local Tumor Stage and Nodes Stage.Results:Of the 48 patients,33 males,15 females,range 25–78 years?mean age was 54.4 years?.Histology found six?12.5%?ypT₀,fifteen?31.3%?ypT_1-2,twenty two?45.8%?yp T₃,five?10.4%?ypT₄,thirty-one?64.6%?ypN₀,seventeen?35.4%?ypN₊and four patients with PCR?pathological complete response,ypT₀N₀??8.3%?The accuracy of T staging were 39.6%,50%,56.3%on ERUS?CT and MRI.Considering the tumors that did not penetrate the muscle layer of the rectal wall?T₁,and T₂?,The accuracy of T_1-2 staging were 20%?6.7%?33.3%on ERUS?CT and MRI.The accuracy of T_3-4 staging were 59.3%,85.2%,81.5%on ERUS?CT and MRI.the ppv?positive predictive value?of T_1-2staging were 60%,50%,83.3%on ERUS?CT and MRI.The accuracy of N staging were 64.6%?60.4%?56.3%.Conclusions:The accuracy of staging on the three kinds radiological examination was found to be low.The accuracy of T staging were 39.6%to56.3%.Overstaging on T_0-2-2 were the reason of misleading.MRI got a better performance on ppv?positive predictive value?of T_1-2 staging than others.The accuracy of N staging were 56.3%to 64.6%on ERUS?CT and MRI.The sentitivity of ERUS was only 17.6%and CT?MRI got the better performance on NPV?negative predictive value?and sentitivity.The accuracy of restaging after neoadjuvant therapy in rectal cancer is still a big challenge,we should not cha nge the operationg plan because the accuracy of staging were low.