Computed tomographic colonography versus double-contrast barium enema for the preoperative evaluation of rectal cancer.

Abstract

PURPOSE:

We investigated whether or not computed tomographic colonography (CTC) is a viable alternative to double-contrast barium enema (BE) for a preoperative rectal cancer evaluation.

METHODS:

The size and distance from the anal canal to the lower or upper tumor borders were laterally measured in 147 patients who underwent CTC and BE. Measurements were grouped into early cancer, advanced, and after chemoradiation therapy (CRT).

RESULTS:

In the early and advanced cancer groups, all lesions were visualized by BE. In contrast, 3 (7.8%) early and 8 (7.3%) advanced cases, located at the anterior wall near the anal canal, were not visualized by CTC because of liquid level formation. In the CRT group, 16 (23.5%) and 4 (5.8%) cases were not visualized by CTC and BE, respectively. The BE and CTC size measurements were similar among cohorts. However, the distance from the anal canal's superior margin tended to be longer with BE, especially in early cancer. The differences in distance from the anal canal were significantly larger in the early cancer group than in the other two groups (p = 0.0024).

CONCLUSION:

CTC may be a viable alternative imaging modality in some cases. However, BE should be employed in anterior wall cases near the anal canal and CRT cases.

• Authors: Shin Murai, Kazushige Kawai, Hirofumi Sonoda, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Hiroyuki Anzai, Soichiro Ishihara
• Journal: Surgery today (Surg Today) Vol. 52 Issue 5 Pg. 755-762 (May 2022) ISSN: 1436-2813 [Electronic] Japan
• PMID: 34816321 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.

Chemical References

• Contrast Media
• Barium Sulfate

Topics

• Barium Enema
• Barium Sulfate
• Colonography, Computed Tomographic (methods)
• Colorectal Neoplasms (diagnostic imaging)
• Contrast Media
• Enema (methods)
• Humans
• Rectal Neoplasms (diagnostic imaging, therapy)
• Sensitivity and Specificity