D Xu1, H-X Ju2, C-W Qian3, F Jiang4. 1. Department of Ultrasound, Zhejiang Cancer Hospital, Gongshu, Hangzhou, China. Electronic address: xudnj@163.com. 2. Department of Surgery, Zhejiang Cancer Hospital, Gongshu, Hangzhou, China. 3. Department of Ultrasound, Zhejiang Cancer Hospital, Gongshu, Hangzhou, China. 4. Department of Radiotherapy, Zhejiang Cancer Hospital, Gongshu, Hangzhou, China.
Abstract
AIM: To compare the effectiveness of transrectal ultrasonography (TRUS) with that of postoperative pathological examination in staging rectal carcinoma before surgery and before and after radiotherapy. MATERIALS AND METHODS: A prospective study was undertaken comprising 62 patients with stage T3 or T4 rectal carcinoma confirmed by endoscopic biopsy. RESULTS: TRUS showed significant differences (p < 0.01) in tumour echogenicity and volume, border delineation, local invasion, and draining lymph node involvement before and after radiotherapy, and significant reduction in blood flow resistance index after radiotherapy but no difference (p > 0.05) in the classification of tumour blood flow. In ultrasonographic assessments, 53 of the 62 cases (85.5%) showed lower T stages after radiotherapy. TRUS showed an accuracy of 94.1% for T2 cases, 77.3% for T3 cases, and 83.3% for T4 cases, and an overall accuracy of 87.1% in comparison with the results of postoperative pathological examination. CONCLUSION: TRUS is expected to play a vital role in the accurate preoperative staging of rectal carcinoma with the increasing utilization of adjuvant radiotherapy in rectal carcinoma and to contribute to the assessment of treatment.
AIM: To compare the effectiveness of transrectal ultrasonography (TRUS) with that of postoperative pathological examination in staging rectal carcinoma before surgery and before and after radiotherapy. MATERIALS AND METHODS: A prospective study was undertaken comprising 62 patients with stage T3 or T4 rectal carcinoma confirmed by endoscopic biopsy. RESULTS: TRUS showed significant differences (p < 0.01) in tumour echogenicity and volume, border delineation, local invasion, and draining lymph node involvement before and after radiotherapy, and significant reduction in blood flow resistance index after radiotherapy but no difference (p > 0.05) in the classification of tumour blood flow. In ultrasonographic assessments, 53 of the 62 cases (85.5%) showed lower T stages after radiotherapy. TRUS showed an accuracy of 94.1% for T2 cases, 77.3% for T3 cases, and 83.3% for T4 cases, and an overall accuracy of 87.1% in comparison with the results of postoperative pathological examination. CONCLUSION: TRUS is expected to play a vital role in the accurate preoperative staging of rectal carcinoma with the increasing utilization of adjuvant radiotherapy in rectal carcinoma and to contribute to the assessment of treatment.