IMPROVED ACCURACY OF COMPUTED-TOMOGRAPHY IN LOCAL STAGING OF RECTAL-CANCER USING WATER ENEMA

A new technique in the preoperative staging computed tomography of rec tal cancer using a water enema to promote full distension of the rectu m was compared with standard CT in a non-randomised blind study, One h undred and twenty-one patients were enrolled, There were 57 in the wat er enema CT group and 64 in the standard group. The stage of the disea se was assessed following strict criteria and tested against the patho logical examination of the resected specimen, Water enema CT was signi ficantly more accurate than standard CT with an accuracy of 84.2% vs. 62.5% (Kappa: 0.56 vs. 0.33: Kappa Weighted: 0.93 vs. 0.84). The diagn ostic gain was mainly evident in the identification of rectal wall inv asion within or beyond the muscle layer (94.7 vs. 61). The increased a ccuracy was 33.7% (CL95: 17-49; P < 0.001). The results indicate that water enema CT should replace CT for staging rectal cancer and may off er an alternative to endorectal ultrasound.