Contrast-enhanced computed tomography colonography in preoperative distinction between T1-T2 and T3-T4 staging of colon cancer

Nicola Flor, Miriam Mezzanzanica, Paolo Rigamonti, Elena Guerini Rocco, Silvano Bosari, Andrea Pisani Ceretti, Simone Soldi, Mauro Peri, Francesco Sardanelli, Gian Paolo Cornalba

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Abstract

Rationale and Objectives: To predict the T stage of nonrectal colon cancer using contrast-enhanced computed tomography colonography. Materials and Methods: Sixty-one patients with 67 nonrectal colon cancers consecutively underwent contrast-enhanced computed tomography colonography after an incomplete colonoscopy. Two readers evaluated wall deformity and perilesional fat abnormality on three-dimensional double contrast enema-like views and multiplanar reconstructions. Pathology was used as the standard of reference. McNemar, Fisher, and Cohen κ statistics were used. Results: At pathologic examination, we found the following stages: T1 (n = 5), T2 (n = 10), T3 (n = 41), T4a (n = 6), and T4b (n = 5). Intraobserver and interobserver reproducibilities were almost perfect for wall deformity (κ = 1.00 and κ = 0.88, respectively), substantial for perilesional fat abnormality (κ = 0.79 and κ = 0.74, respectively). Using the results of the more experienced reader, accuracy of wall deformity ≥50% (apple-core) alone for T ≥ 3 was 62 of 67 (0.93, 95% confidence interval [CI] 0.83-0.97) and that of perilesional fat abnormality alone was 37 of 67 (0.55, 95% CI 0.43-0.67) (P <.001). Predictive value for ≥ T3 of the association wall deformity ≥50% with perilesional fat abnormality was 22 of 22 (1.00, 95% CI 0.85-1.00), higher, but not significantly, than that of wall deformity ≥50% with normal perilesional fat 29 of 33 (0.88, 95% CI 0.72-0.97) (P = .148, Fisher exact test). Conclusions: The presence of apple-core wall deformity, regardless of perilesional fat abnormality, is highly predictive of stage T3 or higher.

Original languageEnglish
Pages (from-to)590-595
Number of pages6
JournalAcademic Radiology
Volume20
Issue number5
DOIs
Publication statusPublished - May 2013

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Colonic Neoplasms
Fats
Tomography
Confidence Intervals
Malus
Enema
Colonoscopy
Pathology

Keywords

  • Colon cancer
  • Contrast-enhanced CT
  • CT colonography
  • T staging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Contrast-enhanced computed tomography colonography in preoperative distinction between T1-T2 and T3-T4 staging of colon cancer. / Flor, Nicola; Mezzanzanica, Miriam; Rigamonti, Paolo; Rocco, Elena Guerini; Bosari, Silvano; Ceretti, Andrea Pisani; Soldi, Simone; Peri, Mauro; Sardanelli, Francesco; Cornalba, Gian Paolo.

In: Academic Radiology, Vol. 20, No. 5, 05.2013, p. 590-595.

Research output: Contribution to journalArticle

Flor, Nicola ; Mezzanzanica, Miriam ; Rigamonti, Paolo ; Rocco, Elena Guerini ; Bosari, Silvano ; Ceretti, Andrea Pisani ; Soldi, Simone ; Peri, Mauro ; Sardanelli, Francesco ; Cornalba, Gian Paolo. / Contrast-enhanced computed tomography colonography in preoperative distinction between T1-T2 and T3-T4 staging of colon cancer. In: Academic Radiology. 2013 ; Vol. 20, No. 5. pp. 590-595.
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abstract = "Rationale and Objectives: To predict the T stage of nonrectal colon cancer using contrast-enhanced computed tomography colonography. Materials and Methods: Sixty-one patients with 67 nonrectal colon cancers consecutively underwent contrast-enhanced computed tomography colonography after an incomplete colonoscopy. Two readers evaluated wall deformity and perilesional fat abnormality on three-dimensional double contrast enema-like views and multiplanar reconstructions. Pathology was used as the standard of reference. McNemar, Fisher, and Cohen κ statistics were used. Results: At pathologic examination, we found the following stages: T1 (n = 5), T2 (n = 10), T3 (n = 41), T4a (n = 6), and T4b (n = 5). Intraobserver and interobserver reproducibilities were almost perfect for wall deformity (κ = 1.00 and κ = 0.88, respectively), substantial for perilesional fat abnormality (κ = 0.79 and κ = 0.74, respectively). Using the results of the more experienced reader, accuracy of wall deformity ≥50{\%} (apple-core) alone for T ≥ 3 was 62 of 67 (0.93, 95{\%} confidence interval [CI] 0.83-0.97) and that of perilesional fat abnormality alone was 37 of 67 (0.55, 95{\%} CI 0.43-0.67) (P <.001). Predictive value for ≥ T3 of the association wall deformity ≥50{\%} with perilesional fat abnormality was 22 of 22 (1.00, 95{\%} CI 0.85-1.00), higher, but not significantly, than that of wall deformity ≥50{\%} with normal perilesional fat 29 of 33 (0.88, 95{\%} CI 0.72-0.97) (P = .148, Fisher exact test). Conclusions: The presence of apple-core wall deformity, regardless of perilesional fat abnormality, is highly predictive of stage T3 or higher.",
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T1 - Contrast-enhanced computed tomography colonography in preoperative distinction between T1-T2 and T3-T4 staging of colon cancer

AU - Flor, Nicola

AU - Mezzanzanica, Miriam

AU - Rigamonti, Paolo

AU - Rocco, Elena Guerini

AU - Bosari, Silvano

AU - Ceretti, Andrea Pisani

AU - Soldi, Simone

AU - Peri, Mauro

AU - Sardanelli, Francesco

AU - Cornalba, Gian Paolo

PY - 2013/5

Y1 - 2013/5

N2 - Rationale and Objectives: To predict the T stage of nonrectal colon cancer using contrast-enhanced computed tomography colonography. Materials and Methods: Sixty-one patients with 67 nonrectal colon cancers consecutively underwent contrast-enhanced computed tomography colonography after an incomplete colonoscopy. Two readers evaluated wall deformity and perilesional fat abnormality on three-dimensional double contrast enema-like views and multiplanar reconstructions. Pathology was used as the standard of reference. McNemar, Fisher, and Cohen κ statistics were used. Results: At pathologic examination, we found the following stages: T1 (n = 5), T2 (n = 10), T3 (n = 41), T4a (n = 6), and T4b (n = 5). Intraobserver and interobserver reproducibilities were almost perfect for wall deformity (κ = 1.00 and κ = 0.88, respectively), substantial for perilesional fat abnormality (κ = 0.79 and κ = 0.74, respectively). Using the results of the more experienced reader, accuracy of wall deformity ≥50% (apple-core) alone for T ≥ 3 was 62 of 67 (0.93, 95% confidence interval [CI] 0.83-0.97) and that of perilesional fat abnormality alone was 37 of 67 (0.55, 95% CI 0.43-0.67) (P <.001). Predictive value for ≥ T3 of the association wall deformity ≥50% with perilesional fat abnormality was 22 of 22 (1.00, 95% CI 0.85-1.00), higher, but not significantly, than that of wall deformity ≥50% with normal perilesional fat 29 of 33 (0.88, 95% CI 0.72-0.97) (P = .148, Fisher exact test). Conclusions: The presence of apple-core wall deformity, regardless of perilesional fat abnormality, is highly predictive of stage T3 or higher.

AB - Rationale and Objectives: To predict the T stage of nonrectal colon cancer using contrast-enhanced computed tomography colonography. Materials and Methods: Sixty-one patients with 67 nonrectal colon cancers consecutively underwent contrast-enhanced computed tomography colonography after an incomplete colonoscopy. Two readers evaluated wall deformity and perilesional fat abnormality on three-dimensional double contrast enema-like views and multiplanar reconstructions. Pathology was used as the standard of reference. McNemar, Fisher, and Cohen κ statistics were used. Results: At pathologic examination, we found the following stages: T1 (n = 5), T2 (n = 10), T3 (n = 41), T4a (n = 6), and T4b (n = 5). Intraobserver and interobserver reproducibilities were almost perfect for wall deformity (κ = 1.00 and κ = 0.88, respectively), substantial for perilesional fat abnormality (κ = 0.79 and κ = 0.74, respectively). Using the results of the more experienced reader, accuracy of wall deformity ≥50% (apple-core) alone for T ≥ 3 was 62 of 67 (0.93, 95% confidence interval [CI] 0.83-0.97) and that of perilesional fat abnormality alone was 37 of 67 (0.55, 95% CI 0.43-0.67) (P <.001). Predictive value for ≥ T3 of the association wall deformity ≥50% with perilesional fat abnormality was 22 of 22 (1.00, 95% CI 0.85-1.00), higher, but not significantly, than that of wall deformity ≥50% with normal perilesional fat 29 of 33 (0.88, 95% CI 0.72-0.97) (P = .148, Fisher exact test). Conclusions: The presence of apple-core wall deformity, regardless of perilesional fat abnormality, is highly predictive of stage T3 or higher.

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KW - Contrast-enhanced CT

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KW - T staging

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