Height of Rectal Cancer: A Comparison between Rectoscopic and Different MRI Measurements

Purpose. To compare rigid rectoscopy with three different MRI measurement techniques for rectal cancer height determination, all starting at the anal verge, in order to evaluate whether MRI measurements starting from the anal verge could be an alternative to rigid rectoscopy. Moreover, potential cut...

Full description

Saved in:
Bibliographic Details
Main Authors: U. I. Attenberger, J. Winter, F. N. Harder, I. Burkholder, D. Dinter, S. Kaltschmidt, P. Kienle, S. O. Schoenberg, R. Hofheinz
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/2130705
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849387223429939200
author U. I. Attenberger
J. Winter
F. N. Harder
I. Burkholder
D. Dinter
S. Kaltschmidt
P. Kienle
S. O. Schoenberg
R. Hofheinz
author_facet U. I. Attenberger
J. Winter
F. N. Harder
I. Burkholder
D. Dinter
S. Kaltschmidt
P. Kienle
S. O. Schoenberg
R. Hofheinz
author_sort U. I. Attenberger
collection DOAJ
description Purpose. To compare rigid rectoscopy with three different MRI measurement techniques for rectal cancer height determination, all starting at the anal verge, in order to evaluate whether MRI measurements starting from the anal verge could be an alternative to rigid rectoscopy. Moreover, potential cut-off values for MRI in categorizing tumor height measurements were evaluated. Methods. In this retrospective study, 106 patients (75 men, 31 female, mean age 64±11.59 years) with primary rectal cancer underwent rigid rectoscopy as well as MR imaging. Three different measurements (MRI1–3) in T2w sagittal scans were used to evaluate the exact distance from the anal verge (AV) to the distal ending of the tumor (MRI1: two unbowed lines, AV to the upper ending of the anal canal and upper ending of the anal canal to the lower border of the tumor; MRI2: one straight line from the AV to the lower boarder of the tumor; MRI3: a curved line beginning at the AV and following the course of the rectum wall ending at the lower border of the tumor). Furthermore, agreement between the gold standard rigid rectoscopy (UICC classification: low part, 0-6 cm; mid part, 6-12 cm; and high part, >12 cm) and each MRI measuring technique was analyzed. Results. Only a fair correlation in terms of individual measures between rectoscopy and all 3 MRI measurement techniques was shown. The proposed new cut-off values utilizing ROC analysis for the three different MRI beginning at the anal verge were low 0-7.7 cm, mid 7.7-13.3 cm, and high>13.3 cm (MRI1); low 0-7.4 cm, mid 7.4-11.2 cm, and high>11.2 cm (MRI2); and low 0-7.1 cm, mid 7.1-13.7 cm, and high>13.7 cm (MRI3). For MRI1 and MRI3, the agreement to the gold standard was substantial (r=0.66, r=0.67, respectively). Conclusion. This study illustrates that MRI1 and MRI3 measures can be interchangeably used as a valid method to determine tumor height compared to the gold standard rigid rectoscopy.
format Article
id doaj-art-2c572abff11e43cfb55deeec054af505
institution Kabale University
issn 1687-6121
1687-630X
language English
publishDate 2020-01-01
publisher Wiley
record_format Article
series Gastroenterology Research and Practice
spelling doaj-art-2c572abff11e43cfb55deeec054af5052025-08-20T03:55:17ZengWileyGastroenterology Research and Practice1687-61211687-630X2020-01-01202010.1155/2020/21307052130705Height of Rectal Cancer: A Comparison between Rectoscopic and Different MRI MeasurementsU. I. Attenberger0J. Winter1F. N. Harder2I. Burkholder3D. Dinter4S. Kaltschmidt5P. Kienle6S. O. Schoenberg7R. Hofheinz8Department of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Rechts der Isar, Technical University Munich, Munich, GermanyDepartment of Nursing and Health, University of Applied Sciences of the Saarland, Saarbruecken, GermanyRadiologie Schwetzingen, Schwetzingen, GermanyRadiologie Westpfalz-Klinikum, Kaiserslautern, GermanyGeneral and Visceral Surgery, Theresienkrankenhaus and St. Hedwig-Klinik GmbH, Mannheim, GermanyDepartment of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Medical Oncology, University Hospital Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyPurpose. To compare rigid rectoscopy with three different MRI measurement techniques for rectal cancer height determination, all starting at the anal verge, in order to evaluate whether MRI measurements starting from the anal verge could be an alternative to rigid rectoscopy. Moreover, potential cut-off values for MRI in categorizing tumor height measurements were evaluated. Methods. In this retrospective study, 106 patients (75 men, 31 female, mean age 64±11.59 years) with primary rectal cancer underwent rigid rectoscopy as well as MR imaging. Three different measurements (MRI1–3) in T2w sagittal scans were used to evaluate the exact distance from the anal verge (AV) to the distal ending of the tumor (MRI1: two unbowed lines, AV to the upper ending of the anal canal and upper ending of the anal canal to the lower border of the tumor; MRI2: one straight line from the AV to the lower boarder of the tumor; MRI3: a curved line beginning at the AV and following the course of the rectum wall ending at the lower border of the tumor). Furthermore, agreement between the gold standard rigid rectoscopy (UICC classification: low part, 0-6 cm; mid part, 6-12 cm; and high part, >12 cm) and each MRI measuring technique was analyzed. Results. Only a fair correlation in terms of individual measures between rectoscopy and all 3 MRI measurement techniques was shown. The proposed new cut-off values utilizing ROC analysis for the three different MRI beginning at the anal verge were low 0-7.7 cm, mid 7.7-13.3 cm, and high>13.3 cm (MRI1); low 0-7.4 cm, mid 7.4-11.2 cm, and high>11.2 cm (MRI2); and low 0-7.1 cm, mid 7.1-13.7 cm, and high>13.7 cm (MRI3). For MRI1 and MRI3, the agreement to the gold standard was substantial (r=0.66, r=0.67, respectively). Conclusion. This study illustrates that MRI1 and MRI3 measures can be interchangeably used as a valid method to determine tumor height compared to the gold standard rigid rectoscopy.http://dx.doi.org/10.1155/2020/2130705
spellingShingle U. I. Attenberger
J. Winter
F. N. Harder
I. Burkholder
D. Dinter
S. Kaltschmidt
P. Kienle
S. O. Schoenberg
R. Hofheinz
Height of Rectal Cancer: A Comparison between Rectoscopic and Different MRI Measurements
Gastroenterology Research and Practice
title Height of Rectal Cancer: A Comparison between Rectoscopic and Different MRI Measurements
title_full Height of Rectal Cancer: A Comparison between Rectoscopic and Different MRI Measurements
title_fullStr Height of Rectal Cancer: A Comparison between Rectoscopic and Different MRI Measurements
title_full_unstemmed Height of Rectal Cancer: A Comparison between Rectoscopic and Different MRI Measurements
title_short Height of Rectal Cancer: A Comparison between Rectoscopic and Different MRI Measurements
title_sort height of rectal cancer a comparison between rectoscopic and different mri measurements
url http://dx.doi.org/10.1155/2020/2130705
work_keys_str_mv AT uiattenberger heightofrectalcanceracomparisonbetweenrectoscopicanddifferentmrimeasurements
AT jwinter heightofrectalcanceracomparisonbetweenrectoscopicanddifferentmrimeasurements
AT fnharder heightofrectalcanceracomparisonbetweenrectoscopicanddifferentmrimeasurements
AT iburkholder heightofrectalcanceracomparisonbetweenrectoscopicanddifferentmrimeasurements
AT ddinter heightofrectalcanceracomparisonbetweenrectoscopicanddifferentmrimeasurements
AT skaltschmidt heightofrectalcanceracomparisonbetweenrectoscopicanddifferentmrimeasurements
AT pkienle heightofrectalcanceracomparisonbetweenrectoscopicanddifferentmrimeasurements
AT soschoenberg heightofrectalcanceracomparisonbetweenrectoscopicanddifferentmrimeasurements
AT rhofheinz heightofrectalcanceracomparisonbetweenrectoscopicanddifferentmrimeasurements