Multi-slice CT For Preoperative Staging Of Colon Cancer

Objective: Cancer of the colon is the most commom cancer in men and women.The selection of treatment and the prognosis of colon cancer are relevant to the clinicstages. While the accuracy of diagnosis related inti-mately with the depth of tumorinvasion (T), local lymgh node metastasis (N) and metastasis to neighboring or remoteorgans (M). Accurate preoperative assessment of tumour extend is essential forchoosing the appropriate therapeutic stragegy, and thus for patient prognosis.Multi-slice CT (MSCT) is a recent method for preoperative staging of the colon cancer. Itprovides an accurate evaluation about the depth of tumor invasion, lymph node ordistant metastases. So MSCT could be a new method for staging of colon cancer.Toassess MSCT diagnostic value in the staging of colonic carcinoma.Meterial and Method:45patients at our general surgery center undergoingprimary resection for colon cancer during2009-2011were included. The patients wereunderewent MSCT volume scan after hypotonic pneumcolon. After the scanning all theprecontrast, enhancement and reconstruction MSCT images were analyzed andestimated independently by two radiologists blinded to histological stage and outcome.Images of the primary tumour were evaluated as CT-based TNM staging according tothe tumor site, direct invasion of an adjacent organ, colonic fat, involvement of lymphnode and mesenteric surface of the colon and distant metastases.Results: The overall sensitivity of MSCT for T-stage is100%and92.86%forinvasion of mesenteric surface. The overall accuracy is91.11%, positive predictivevalue (PPV)86.36%, and negative predictive value (NPV)88%. For lymph nodemetastases the sensitivity of MSCT staging is85.71%, accuracy80%, PPV75%andNPV85.71%.Conclusion: Our results suggest that it is therefore a robust method for preoperative TNM staging of colon cancer. We have demonstrated that preoperativeTNM staging can predict the clinical outcome for ‘good’ and ‘poor’ prognosis tumourswith the same accuracy as histopathology. It is significant for choosing the appropriatetherapeutic strategy.