• Academic radiology · Dec 2015

    Randomized Controlled Trial

    Perioperative Colonic Evaluation in Patients with Rectal Cancer; MR Colonography Versus Standard Care.

    • Michael Patrick Achiam, Vibeke Løgager, Vera Lund Rasmussen, Cecilie Okholm, Talie Mollerup, Henrik S Thomsen, and Jacob Rosenberg.
    • Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Electronic address: michael.patrick.achiam.01@regionh.dk.
    • Acad Radiol. 2015 Dec 1; 22 (12): 1522-8.

    Rationale And ObjectivesPreoperative colonic evaluation is often inadequate because of cancer stenosis making a full conventional colonoscopy (CC) impossible. In several studies, cancer stenosis has been shown in up to 16%-34% of patients with colorectal cancer. The purpose of this study was to prospectively evaluate the completion rate of preoperative colonic evaluation and the quality of perioperative colonic evaluation using magnetic resonance colonography (MRC) in patients with rectal cancer.Materials And MethodsPatients diagnosed with rectal cancer were randomized to either group A: standard preoperative diagnostic work-up or group B: preoperative MR diagnostic work-up (standard preoperative diagnostic work-up + MRC). A complete and adequate perioperative clean-colon evaluation (PCE) was defined as either a complete preoperative colonic evaluation or a complete colonic evaluation within 3 months postoperatively.ResultsTwenty-eight patients were randomized to group A and 28 to group B. Complete preoperative colonic evaluation with CC was achieved in 39% patients in group A and 93% for group B (Fisher's exact test, P < .001). PCE with CC was achieved in 64% and 93% in groups A and B, respectively (Fisher's exact test, P = .02). In group A, one synchronous cancer was found by CC. However, the location was misjudged as a sigmoid cancer. In group B, two synchronous cancers were found in the same patient who had an insufficient preoperative CC due to an obstructing rectal cancer.ConclusionsMRC is a valuable tool and is recommended as part of the standard preoperative evaluation for patients with rectal cancer.Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

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