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ECR 2015 / C-1504
Computed Tomography vs Magnetic Resonance Imaging in the evaluation of intra- and extra-peritoneal rectal cancer    
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Congress: ECR 2015
Poster No.: C-1504
Type: Scientific Exhibit
Keywords: Cancer, Staging, MR, CT, Colon, Abdomen
Authors: C. Conforti, M. Revelli, F. Paparo, C. Puppo, L. Bacigalupo, M. Furnari, G. A. Binda, G. A. Rollandi; Genoa/IT
DOI:10.1594/ecr2015/C-1504

Aims and objectives

The discrimination between intra- and extraperitoneal rectal cancer has important implications for both oncologic and surgical grounds, since these different tumors have to be treated in different ways and since they present different risks of local recurrence and different prognosis [1]: tumors located above the peritoneal reflection have to be considered as colon cancers, since they share the same clinical course, while locally advanced (>T3a or N+) extraperitoneal rectal tumors take advantage of combined chemoradiation preferentially administered before surgery (i.e. neoadjuvant chemoradiation) [2, 3].

Recent studies dealt with the role of MRI in directly showing the relationship between the peritoneal reflection and the tumor on high-resolution images [4, 5], thus providing an accurate preoperative identification of tumor’s location and a tailored treatment planning. However, patients with rectal cancer routinely undergo a contrast-enhanced CT scan of chest and abdomen looking for distant metastasis: in this scenario, a direct visualization of the peritoneal reflection (and consequently of the location of tumors) may be possible on CT images as well as on MR images. The purpose of our study was to compare the diagnostic performance of CT with that of MRI to determine the extra- or intraperitoneal location of rectal cancers, using surgical exploration as reference standard. 

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