Purpose: To demonstrate the usefulness of hydrogel-CT for detecting and staging of rectosigmoid colon cancer.
Materials and methods: Fifty-four patients with rectosigmoid colon cancers underwent routine CT without (n=27) and with (n=27) rectum distension using a sonographic gel. Rectum distensibility and tumor visualization were evaluated. T and N stages on CT independently recorded by two radiologists were correlated with pathologic staging. Staging accuracies were compared using Fisher's exact test. Diagnostic performances in differentiating <T3 from ≥T3 and N0 from ≥N1 were evaluated using areas under the receiver operating characteristic curves (AZ).
Results: Rectum distensibility (3.52) and tumor visualization (3.70) were significantly more scored in the distended group than in the control group (1.44 and 2.04) (P<0.0001). Pathologic and CT staging were more correlated in the distended group in both reviewers. Accuracy for staging was higher in the distended group (T: 50-85.2%/N: 59.3-92.6%) than in the control group (T: 45.5-62.5%/N: 33.3-59.3%) without statistical significance except N staging for reviewer 2 (P=0.0091). AZ values for T and N staging in the distended group (T: 0.827-0.989/N: 0.858-0.980) were also higher than in the control group (T: 0.817-0.907/N: 0.544-0.654).
Conclusion: Hydrogel-CT can provide better diagnostic performance for T and N staging of rectosigmoid colon cancer.
Keywords: Hydrogel; Multidetector computed tomography; Neoplasm staging; Neoplasms; Rectum.
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