Rectal tumour staging: MR imaging using pelvic phased-array and endorectalcoils vs endoscopic ultrasonography

The aim of this study was to compare MR imaging and endoscopic ultrasonogra phy (EUS) for the local staging of rectal tumours. Forty-nine patients were examined on a 1.5-T MR unit using either a pelvic phased-array coil (n = 3 7) alone or combined with an endorectal coil (n = 12). Sagittal and axial s equences with T2-weighted fast spin-echo and axial T1-weighted spin-echo te chniques were employed The EUS technique was performed using a flexible end osonoscope. The results were compared with findings at histopathological se ctioning of the specimen. The T-stage on MR correlated with histopathology in 32 of 49 patients and on EUS in 29 of 49 patients. The N-stage on MR cor related with histopathology in 22 of 49 patients and on EUS in 26 of 49 pat ients. Tumour penetration of the rectal wall was predicted by MR with 86% s ensitivity and 65% specificity, and by EUS with 89% sensitivity and 33%. sp ecificity. Preoperative radiotherapy was administered to 40 of the patients after the examinations which may explain some of the overstaging by MR and EUS. Three patients with surgically and histopathologically confirmed inva sion of neighbouring II organs in the pelvis were detected preoperatively o n MR but none on EUS. Tumour penetration of the rectal wall and local lymph node metastases cannot accurately be predicted with MR or EUS. Magnetic re sonance, however, seems to be more useful for preoperative identification o f clinically occult advanced disease.