Impact of contrast-enhanced computed tomography colonography on laparoscopic surgical planning of colorectal cancer

Nicola Flor, Andrea Pisani Ceretti, Miriam Mezzanzanica, Paolo Rigamonti, Mauro Peri, Silvia Tresoldi, Simone Soldi, Benedetto Mangiavillano, Francesco Sardanelli, Gian Paolo Cornalba

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: To evaluate the impact of contrast-enhanced computed tomography colonography (CE-CTC) on laparoscopic surgery planning in patient with stenosing colorectal cancer. Materials and methods: Sixty-nine patients with endoscopically proven colorectal cancer underwent CE-CTC, after incomplete conventional colonoscopy. Two experienced radiologists evaluated site, length, and TNM staging of colorectal cancers on three-dimensional double contrast enema-like views, 2D axial and multiplanar reconstructions. All the patients underwent colorectal resection and surgery bulletin, pathology of surgical specimens, and radiological follow-up at about 8 months were used as reference standard. Results: The detection rate of colorectal cancer was 100 % (75/75); CE-CTC allowed for a diagnosis of a synchronous colorectal cancer in five patients (7 %). CE-CTC correctly judged the site of the lesions in all the cases; clinically significant localization errors at conventional colonoscopy were noted in 3 out of 69 patients (4 %). Additional colonic polyps greater than 6 mm in diameter were found in 21 out of 69 patients (30 %); in two patients (3 %) the surgeon performed an enlarged colectomy to include synchronous polyps proximal to colorectal cancer. Sensitivity, specificity, PPV, NPV, and accuracy were for T1-T2 vs. T3-T4: 96 %, 71 %, 92 %, 87 %, and 91 %, respectively; for N: 94 %, 42 %, 64 %, 86 %, and 70 %; for M: 100 %, 100 %, 83 %, 100 %, and 97 %. There were no complications associated with CE-CTC. Conclusion: Information given by CE-CTC concerning colorectal cancer location and synchronous colonic cancers and polyps changed the laparoscopic surgical strategy in almost 14 % of patients.

Original languageEnglish
Pages (from-to)1024-1032
Number of pages9
JournalAbdominal Imaging
Volume38
Issue number5
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Colon cancer
  • Computed tomography
  • Contrast-enhanced CT
  • CT colonography
  • Laparoscopic colorectal surgery
  • Rectal cancer

ASJC Scopus subject areas

  • Gastroenterology
  • Urology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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