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Korean Journal of Clinical Oncology > Volume 6(2); 2010 > Article
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Korean J Clin Oncol. 2010;6(2): 43-51.         doi: https://doi.org/10.14216/kjco.10018
Early experience of three dimensional transrectal ultrasonography: comparison of diagnostic accuracy between two dimensional transrectal ultrasonography, computed tomography and magnetic resonance imaging in rectal cancer patients with preoperative chem
Je Gyu Rye, Young Wan Kim, Nam Kyu Kim, Hyuk Huh, Byung Soh Min, Kang Young Lee, Seung Kuk Sohn
Colorectal Cancer Special Clinic, Yonsei University Health system, Departments of Surgery, Seoul, Korea
수술 전 항암방사선 치료를 시행한 직장암 환자에서 3차원 경항문 직장초음파의 초기 경험: 2차원 경항문 직장초음파, 컴퓨터 단층촬영 및 자기공명 영상과의 영상진단 정확도 비교.
류제규, 김영완, 김남규, 허혁, 민병소, 이강영, 손승국
연세대학교 의과대학 외과학교실
Corresponding Author: Nam Kyu Kim ,Tel: +82-2-2228-2117, Fax: +82-2-313-8289, Email: namkyuk@yuhs.ac
Received: November 20, 2010;  Accepted: December 23, 2010.
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ABSTRACT
Purpose: This study was designed to evaluate the accuracy of three dimensional transrectal ultrasonography (3D TRUS) when compared to those of two dimensional transrectal ultrasonography, CT and MRI for preoperative chemoradiated rectal cancer. Material and methods : Ninety-nine rectal cancer patients were enrolled. Among them, 58 patients were staged by 2D TRUS, CT and MRI and 41 patients were staged by 3D TRUS, CT and MRI. Depth of tumor invasion (T) and nodal involvement (N) assessed by imaging modalities were compared with pathologic results. Results : When assessing depth of invasion, the accuracy of 2D and 3D TRUS,CT and MRI was 68.9%, 76%,68.6%, and 84.3%, respectively. Overstaging rates were 24.1%, 20%, 21.6%, and 9.6%, and understaging rates were 6.8%, 4%, 9.6% and 6%, respectively. In patients undergoing preoperative chemoradiation, accuracy of depth of invasion was 57.1%, 66.6%, 56.3%, and 62.5%, and overstaging rates were 28.5%,33.3%,43.7%, and 37.5%, and understaging rates were 14.2%,0%,0%, and 0%, respectively. When assessing nodal involvement, accuracy of 2D and 3D TRUS, CT and MRI was 58.62%, 64%, 67.47%, and 73.49%, respectively. In patients undergoing preoperative chemoradiation, accuracy of nodal involvement was 57.1%, 55.5%, 68.75%, and 68.7%, respectively. Conclusion : Although early experience, overall diagnostic accuracy of 3D TRUS was superior to conventional 2D TRUS. As accumulation of experiences, 3D TRUS as well as MRI could be used as a useful tool for preoperative imaging for rectal cancer.
Keywords: Three dimensional TRUS | Rectal cancer | Preoperative staging
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