Comparative efficacy of preoperative staging of local rectal carcinoma by Transrectal Ultrasound and MRI of histopathological confirmed cases at Tertiary care Hospital

Abstract

Colorectal cancer is the third most common cancer worldwide. Approximately 147,000 patients arediagnosed with colorectal cancer each year, and 57,000 deaths are attributed to this disease. The prognosis of patients with colorectal cancer is related to the stage of disease at diagnosis and tumour histology, including differentiation,lymphatic invasion, and extent of tumour-free surgical resection margins. In the present study we look at the two radiological investigative modalities that are routinely used for the local staging i.e.Magnetic resonance imaging (MRI) and Transrectal Ultrasound (TRUS) and try to identify which of two investigative modalities is the best in local staging of carcinoma of rectum. Material and methods:20 patients(11Males and 9 females) with Carcinoma rectum seen from July 2008 to Dec 2010 in outpatient or ward were screened prospectively. After obtaining detailed history, clinical examination was done.The efficacy of Transrectal ultrasound, and Magnetic resonance imaging in preoperative local staging of rectal cancer was compared with histopathological confirmation. Results: In MRI they were represented as three concentric layers (high: interface with submucosa; low: the proper muscle; high: perirectal fat). In TRUS scan all the layers of the wall of the rectum were well made out.The tumor detection rate was 100% (20 of 20) in TRUS and MRI scan.Conclusion:Patients with carcinoma rectum need to be preoperatively staged with a certain degree of accuracy because their treatment depends on the preoperative image based staging. It helps in deciding if surgery or neoadjuvant treatment followed by surgery is the best treatment for that patient, also helps in prognostication of the patient.