The role of multidetector CT in local staging and evaluation of retroperitoneal surgical margin involvement in colon cancer

PURPOSE We aimed to evaluate preoperative T and N staging and retroperitoneal surgical margin (RSM) involvement in colon cancer using multidetector computed tomography (MDCT).METHODSIn this retrospective study, preoperative MDCTs of 141 patients with colon adenocarcinoma were evaluated in terms of T and N staging and retroperitoneal surgical margin involvement by two observers. Results were compared with histopathology.RESULTSIn determining extramural invasion, sensitivity, specificity, positive predictive value (PPV), neg-ative predictive value (NPV), and accuracy of MDCT were 81%, 50%, 95%, 26%, and 81% for ob-server 1 and 87%, 75%, 97%, 27%, and 84% for observer 2, respectively. Moderate interobserver agreement was observed (?=0.425). In determining T stage of the tumor, accuracy of MDCT was 55% for observer 1 and 51% for observer 2. In the detection of lymph node metastasis, sensitivity, specificity, PPV, NPV, and accuracy of MDCT were 84%, 46%, 60%, 74% and 64% for observer 1 and 84%, 56%, 65%, 78%, and 70% for observer 2, respectively. Interobserver agree-ment was substantial (?=0.650). RSM was involved in six cases (4.7%). When only retroperitoneal colon segments were considered, 1.6% of subjects demonstrated RSM involvement. Four of the six RSM-positive tumors were located on sigmoid colon and one tumor was on transverse colon and caecum. Considering all colon tumors, in the detection of RSM involvement, sensitivity and specificity of MDCT were 33% and 81% for observer 1 and 50% and 80% for observer 2. Interob-server agreement was moderate (?=0.518).CONCLUSIONMDCT is a promising technique with moderate interobserver agreement in detection of extra-mural invasion, lymph node metastases, and RSM involvement in colon carcinomas.

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