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Which is more accurate on diagnosis of rectal carcinoma?

The depth of transmural tumor invasion along the rectal wall layers and involvement of the regional lymph nodes constitute major factors in the prognosis of rectal cancer. Therefore accurate preoperative staging of rectal cancer carries a crucial importance in terms of therapy and prognosis. The utility of endorectal ultrasound and pelvic phased-array magnetic resonance imaging has been demonstrated well in the literature. However, studies comparing the diagnostic accuracies of these two techniques are rare.

A research article to be published on 14 June 2008, in the World Journal of Gastroenterology addresses this question. Dr. Halefoglu from Sisli Etfal Training and Research Hospital, Istanbul, Turkey, compared the ability of endorectal ultrasound and pelvic phased-array magnetic resonance imaging for the preoperative staging of rectal carcinoma in a prospective study. 34 patients who had biopsy proven rectal adenocarcinoma were evaluated by both modalities. The imaging results were correlated with the histopathological gold standard evaluations of the surgical specimens.

Phased-array magnetic resonance imaging was found to be slightly superior to endorectal ultrasound in determining the depth of transmural invasion and both techniques have shown similar values in detecting lymph node metastases. Although each technique has been demonstrated as very useful in the preoperative staging of rectal cancer, they can also be used as complementary methods in the accurate staging of rectal cancer.

Both medical professionals and patients are often faced with the dilemma of which technique would be more beneficial in evaluating this increasingly common and at times fatal disease. Dr. Halefoglu resident specialist of Radiology in the Sisli Etfal Training and Research Hospital, Istanbul, Turkey, who also completed his fellowship in the Johns Hopkins Hospital on Body MRI stated that this research could serve as a landmark in enlightening this dilemma.


Contact: Lai-Fu Li
World Journal of Gastroenterology

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