Improvement in T-Staging of Rectal Carcinoma: Using a Novel Endorectal Ultrasonography Technique with Sterile Coupling Gel Filling the Rectum

• Published in: Ultrasound in medicine & biology Vol. 38; no. 4; pp. 574 - 579
• Main Authors: Wang, Yong, Zhou, Chun-Wu, Hao, Yu-Zhi, Li, Lin, Liu, Shang-Mei, Feng, Xiao-Li, Zhou, Zhi-Xiang, Leung, Vivian Yee-Fong
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-04-2012; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cancer; Coupling gel; Endorectal ultrasonography; Endosonography - methods; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gels; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Nuclear polyhedrosis virus; Predictive Value of Tests; Radiology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rectal Neoplasms - diagnostic imaging; Rectal Neoplasms - pathology; Rectal Neoplasms - surgery; Rectum; Sensitivity and Specificity; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; T-staging; Tumors; Endorectal ultrasonography; T-staging; Coupling gel; Rectum; Cancer; Sonography; Nuclear medicine; Rectal disease; Staging; Malignant tumor; Colloidal gel; Echography; Radiology; Digestive diseases; Intestinal disease; Filling; Technique; Rectal carcinoma; Biomedical engineering
• ISSN: 0301-5629; 1879-291X
• DOI: 10.1016/j.ultrasmedbio.2011.12.020

Abstract Our purpose was to study the accuracy of using endorectal ultrasonography (ERUS) with sterile coupling gels filling the rectum in the preoperative T-staging of rectal carcinoma. A total of 189 patients with confirmed rectal carcinoma were recruited. All underwent ERUS and surgery within the week following sonography. EURS was performed by introducing sterile coupling gel into the rectum. Two radiologists looked at the images at the same time and agreed upon staging. Rectal carcinoma was staged from Tis to T4. The accuracy of T-staging by ERUS was 89.95%. The sensitivity, specificity, PPV and NPV for ERUS at different stages were calculated. For early stage (Tis and T1), these values were 93.62%, 97.89%, 93.62% and 97.89%, respectively. ERUS filling with sterile coupling gel in the rectum overcomes the pressure effect from a water bath and the restriction caused by tumor stenosis, thus, greatly improving the accuracy of T-staging. The examination is real-time, safe and inexpensive.