Volume 2, Issue 2, March 2014, Page: 62-67
Characterization of Rectal Neoplasms Using Computerized Tomography
Caroline Edward Ayad, Radiology Department, Sudan University of Science and Technology, Khartoum, Sudan
Wael Abdelgafour Mohammed, Radiology Department, Sudan University of Science and Technology, Khartoum, Sudan
Elsafi Ahmed Abdalla, Radiology Department, Sudan University of Science and Technology, Khartoum, Sudan
Samih Awad Kajaok, Radiology Department, Sudan University of Science and Technology, Khartoum, Sudan
Received: Feb. 7, 2014;       Published: Mar. 20, 2014
DOI: 10.11648/j.ajhr.20140202.15      View  3063      Downloads  129
Abstract
The aims of this study were to characterize and localize the rectal neoplasms by the computerized tomography (CT) and sigmoidoscopy in patients who suspected to have colorectal neoplasms. It was conducted at Radiology and Endoscopy Departments - Soba Hospital-Khartoum-Sudan. This study was extended from October 2011 to December 2011, fifty patients were studied including 34 males and 16 females, and their mean age was 52.5 years ranged from 25–85 years. All patients underwent sigmoidoscopy, axial CT images for pelvis, enhanced with contrast medium, and biopsy as confirmation method. The location of rectal neoplasm was measured in (cm) and the lesions were characterized in CT as circumferential, eccentric rectal wall thickening, masses, tumors according to thier contrast enhancement, in Sigmodioscopy the lesions were classified as seen into polyploidy, obstructive, ulcerative, circumferential lesions and tumor. In the histopathology findings, the lesions were characterized as poor, moderate, well differentiated adenocarcinoma and Tubulovillous adenoma.The study showed that the males were more affected than females. Sigmoidoscopy and CT can predict the lesion type and characterize the changes in the rectum and rectosigmoid region according to its citation from the anal verge significantly at p- value 0.001and 0.038. No significant relation was found between the biopsy results and the presence of the lesions through distance from anus at P-value 0.161. When comparing the CT, sigmoidoscopy and biopsy results; CT has an accuracy of 72% and sensitivity of 69.9 %, sigmoidoscopy has an accuracy of 86.0%and sensitivity of 88.9% where the biopsy has accuracy of 90% and sensitivity 89.1% in differentiation of rectal neoplasms. It can be believed that CT and sigmoidiscopy should be performed together and used as essential methods in diagnosing of rectal neoplasms in addition to histopathological examination as an effective tool in determining the possibility of malignancy of this detected neoplasms.
Keywords
Rectal Neoplasm, CT, Sigmoidscopy
To cite this article
Caroline Edward Ayad, Wael Abdelgafour Mohammed, Elsafi Ahmed Abdalla, Samih Awad Kajaok, Characterization of Rectal Neoplasms Using Computerized Tomography, American Journal of Health Research. Vol. 2, No. 2, 2014, pp. 62-67. doi: 10.11648/j.ajhr.20140202.15
Reference
[1]
Z.R. Jass,. Pathological prognostic indicators in rectal cancer. Hum Pathol; 199425:498–505.
[2]
J.R .Jass. Prognostic value of direct spread in Dukes’ C cases of rectal cancer,. Dis Colon Rectum; 1989,32:477–480.
[3]
R. Tang, J.Y .Wang, J.S. Chen, et al.,. Survival impact of lymph node metastasis in TNM stage III carcinoma of the colon and rectum. J Am Coll Surg1995; 180: 705–712.
[4]
C.G .Willett, K. Badizadegan, M. Ancukiewicz, P.C. Shellito.,. Prognostic factors in stage T3N0 rectal cancer: do all patients require postoperative pelvic irradiation and chemotherapy? Dis Colon Rectum1999; 42:167–173.
[5]
N .Wolmark, B .Fisher, H.S. Wieand., The prognostic value of the modifications of the Dukes’ C class of colorectal cancer. Ann Surg 1986; 203:115–122.
[6]
D.C. Rockey, E .Paulson, D .Niedzwiecki, et al.Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet. 2005; 365(9456):305-311.
[7]
B .Levin, D.A. Lieberman, B .McFarland, et al.Screening and surveil¬lance for the early detection of colorectal cancer and adenomatous a Polyps: joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin2008.;58(3):130-160
[8]
G.A Boyce, M.VSivak, I.C Lavery, et al.Endoscopic ultrasound in the pre-operative staging of rectal carcinoma. Gastrointest Endosc1992; 38(4):468-471
[9]
U. Herzog, M .Von Flue, P .Tondelli, J.P Schuppisser.How accurate is endorectal ultrasound in the preoperative staging of rectal cancer? Dis Colon Rectum; 199336(2):127-134
[10]
A .Waizer, S .Zitron, D. Ben-Baruch, J. Baniel, Y. Wolloch, M .Dintsman..Comparative study for preoperative staging of rectal cancer. Dis Colon Rectum1989; 32(1):53-56
[11]
K.H Rotte, L. Kluhs, H. Kleinau, E.. Kriedemann,.Computed tomography and endosonography in the preoperative staging of rectal carcinoma. Eur J Radiol1989; 9(3):187-190
[12]
P .Videhult, K. Smith, P .Lundin, W. Kraaz.Magnetic resonance imaging for preoperative staging of rectal cancer in clinical practice: high accuracy in predicting circumferential margin with clinical benefit. Colorectal Dis2007; 9(5):412-419.
[13]
S .Purkayastha, P.P. Tekkis, T. Athanasiou, H.S .Tilney, A.W Darzi, A.G .Heriot.. Diagnostic precision of magnetic resonance imaging for preoperative prediction of the circumferential margin involvement in patients with rectal cancer. Colorectal Dis2007;9(5):402-411
[14]
R.Sugita,K.Ito,N.Fujita, S.Takahashi.Diffusion-weighted MRI in abdominal oncology: clinical applications. World J Gastroenterol2010; 16(7):832-836
[15]
R.F .Thoeni..Colorectal cancer. Radiologic staging. Radiol Clin North Am1997; 35(2):457-485
[16]
R. Farouk, H .Nelson, E. Radice, S .Mercill, Gunderson L. Accuracy of computed tomography in determining resectability for locally advanced primary or recurrent colorectal cancers. Am J Surg1998; 175(4):283-287
[17]
R. F. Thoeni, A.A .Moss, P. Schnyder, A. R. Margulis. Detection and staging of primary rectal and recto sigmoid cancer by computed tomography. Radiology 1981; 141: 135–138
[18]
W.M. Thompson, R.A .Halvorsen, W.L .Foster Jr,Roberts L, R. Gibbons..Preoperative and postoperative CT staging of recto sigmoid carcinoma.AJR1986;146:703–710
[19]
Freeny PC, Marks WM, Ryan JA.1986. Colorectal carcinoma evaluation with CT: preoperative staging and detection of postoperative recurrence. Radiology;158:347–353
[20]
A .Maier, M. Fuchsjäger..Preoperative staging of rectal cancer. Eur J Radiol2003;47:89–97
[21]
Thoeni RF. 1997.Colorectal cancer: radiological staging. Radiol Clin N Am;35:457–458
[22]
G .Angelelli, L .Macarini, L. Lupo.Rectal carcinoma :CT staging with water as contrast medium. Radiology 1990; 177: 511–514
[23]
Hundt W, Braunschweig R, Reiser M. 1999.Evaluation of spiral CT in staging of colon and rectum carcinoma. Eur J Radiol;9:78–84
[24]
M .Chiesura-Corona, P.C. Muzzio, G. Giust, Zuliani , S Pucciarelli, P. Toppan. Rectal cancer:.CT local staging with histopathology correlation. Abdom Imaging2001;26:134–138
[25]
A .Taylor, A .Slater, N .Mapstone, et al. ,. Staging rectal cancer: MRI compared to MDCT. Abdom Imaging 2007,32:323–327
[26]
S .Wolberink, R.G .Beets-Tan, D .de Haas-Kock, et al.,.Conventional CT for the prediction of an involved circumferential resection margin in primary rectal cancer. Dig Dis 2007,25:80–85
[27]
Roy Vliegen, Raphaela Dresen, Geerard Beets,Alette Daniels-Gooszen, Alfons Kessels, Jos van Engelshoven, Regina Beets-Tan. ,.The accuracy of Multi-detector row CT for the assessment of tumor invasion of the meso-rectal fascia in primary rectal cancer,Abdom Imaging 2008,33:604–610
[28]
SEER Stat Database: Incidence - SEER 17 Regs Limited-Use + Hurricane Katrina Impacted Louisiana Cases, Nov 2009 Sub (2000-2007)Katrina/Rita Population Adjustment- Linked To County Attributes - Total U.S., 1969-2007 Counties [computer program]: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov), National Can¬cer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2010, based on the November 2009 submission
[29]
G .Murphy, S.S. Devesa, A.J .Cross, P.D Inskip, K.A McGlynn, M.B Cook.Sex disparities in colorectal cancer incidence by anatomic sub site, race and age. Int J Cancer;2010
[30]
American Cancer Society. Cancer Prevention & Early Detection Facts & Figures 2010. Atlanta, GA: American Cancer Society; 2010.
[31]
D. Hayne, R.S .Brown, M .McCormack, M.J .Quinn, H.A Payne, P .Babb..Current trends in colorectal cancer: site, incidence, mortality and survival in England and Wales. Clin Oncol (RColl Radiol) 2001; 13: 448-452
[32]
G .Salerno, I.R .Daniels, B.J .Moran, A .Wotherspoon, G. Brown. Clarifying margins in the multidisciplinary management of rectal cancer: the MERCURY experience. Clin Radiol 2006; 61:916-923
[33]
Levine JS, Ahnen DJ. 2006. Clinical practice. Adenomatous polyps of the colon. N Engl J ed.; 355(24):2551-2557
[34]
S.L .Stewart, J.M. Wike, I .Kato, D.R. Lewis, F .Michaud..A population-based study of colorectal cancer histology in the United States, 1998-2001. Cancer.;107(5 Suppl): 2006;1128-1141
[35]
H .Brenner, J .Chang-Claude, C.M .Seiler, T .Sturmer, M .Hoffmeister.Potential for colorectal cancer prevention of sigmoidoscopy versus colo¬noscopy: population-based case control study. Cancer Epidemiol Bio¬markers Prev.; 2007;16(3):494-499
[36]
C.J .Kahi, Imperiale TF, Juliar BE, Rex DK.Effect of screening colonos¬copy on colorectal cancer incidence and mortality. Clin Gastroenterol Hepatol. 2009; 7(7):770-775
[37]
S.J. Cawthorn, D.V. Parums, N.M .Gibbs, et al. Extent of mesorectal spread and involvement of lateral resection margins as prognostic factors after surgery for rectal cancer. Lancet 1990; 335:1055–1059
[38]
G .Low, L.M .Tho, E .Leen, et al.The role of imaging in the preoperative staging and post-operative follow-up of rectal cancer. Surgeon2008; 6(4):222-231
[39]
Shandra Bipat, S .Afina. Glas, J. M Frederik. Slors, Aeilko H. Zwinderman, M. M. Patrick. Bossuyt, Jaap Stoker, .Rectal Cancer: Local Staging and Assessment of Lymph Node Involvement with Endoluminal US, CT, and MR Imaging—A Meta-Analysis1 , Radiology Volume 232, Number 2004;3 :773-783
[40]
G .Panzironi, M .De Vargas Macciucca, L. Manganaro, et al.:. Preoperative loco regional staging of rectal carcinoma: comparison of MR, TRUS and Multislice CT. Personal experience. Radiol Med (Torino2004); 107:344-355
Browse journals by subject