Abstract
BackgroundPrediction of nodal involvement in colorectal cancer is an important aspect of preoperative workup to determine the necessity of preoperative treatment and the adequate extent of lymphadenectomy during surgery. This study aimed to investigate newer multidetector-row computed tomography (MDCT) findings for better predicting lymph node (LN) metastasis in colorectal cancer.MethodsSeventy patients were enrolled in this study; all underwent MDCT prior to surgery and upfront curative resection for colorectal cancer. LNs with a short-axis diameter (SAD) ≥ 4 mm were identified on MDCT images, and the following measures were recorded by two radiologists independently: two-dimensional (2D) SAD, 2D long-axis diameter (LAD), 2D ratio of SAD to LAD, 2D CT attenuation value, three-dimensional (3D) SAD, 3D LAD, 3D SAD to LAD ratio, 3D CT attenuation value, LN volume, and presence of extranodal neoplastic spread (ENS), as defined by indistinct nodal margin, irregular capsular enhancement, or infiltration into adjacent structures.ResultsForty-six patients presented 173 LNs with a SAD ≥ 4 mm, while 24 patients exhibited pathologically confirmed LN metastases. Receiver operating characteristic analysis revealed that 2D LAD was the most sensitive measure for LN metastases with an area under the curve of 0.752 (cut-off value, 7.05 mm). When combined with CT findings indicating ENS, 2D LAD (> or ≤ 7 mm) showed enhanced predictive power for LN metastases (area under the curve, 0.846; p < 0.001).ConclusionsLAD in axial MDCT imaging is the most sensitive measure for predicting colorectal LN metastases, especially when MDCT findings of ENS are observed.
Highlights
Prediction of nodal involvement in colorectal cancer is an important aspect of preoperative workup to determine the necessity of preoperative treatment and the adequate extent of lymphadenectomy during surgery
The presence of lymph node (LN) metastasis is one of the most important factors associated with poor prognosis [1, 2], and preoperative treatment is considered in selected patients who are
We evaluated the diagnostic accuracy of various radiologic measures obtained by newer multidetector-row computed tomography (MDCT) data and sought to re-evaluate a sensitive approach to predict nodal involvement in colorectal cancer
Summary
Prediction of nodal involvement in colorectal cancer is an important aspect of preoperative workup to determine the necessity of preoperative treatment and the adequate extent of lymphadenectomy during surgery. This study aimed to investigate newer multidetector-row computed tomography (MDCT) findings for better predicting lymph node (LN) metastasis in colorectal cancer. Previous studies have reported the diagnostic accuracy of such CT measures, using axial images [5,6,7,8,9] These reports were based on data collected prior to the Kumamoto et al World Journal of Surgical Oncology (2019) 17:39 availability of current high-resolution CT imaging equipment; the predictive value of CT findings for LN metastasis has not yet been fully validated. Use of multidetector-row computed tomography (MDCT) has become a routine practice for preoperative diagnosis, as its thinner slice data enable various additional analyses, including three-dimensional (3D) reconstruction. It remains unclear how much this novel imaging modality has changed the accuracy of cancer diagnosis
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.