Zobrazovací metody v diagnostice kolorektálního karcinomu
| Title in English | Imaging methods in colorectal cancer diagnostics |
|---|---|
| Authors | |
| Year of publication | 2013 |
| Type | Article in Periodical |
| Magazine / Source | Farmakoterapie |
| MU Faculty or unit | |
| Citation | |
| Field | Oncology and hematology |
| Keywords | ultrasound; endoanal ultrasound; computerized tomography; magnetic resonance; rectal cancer; staging |
| Description | In management of rectal cancer preoperative investigations assist in deciding the optimal treatment. The relation of the tumor edge to the circumferential margin is an important factor in deciding the need for neoadjuvant treatment and determines the prognosis. Those with threatened or involved margins are offered long course chemoradiation to enable R0 surgical resection. Endoanal ultrasound is useful for tumor (T) staging; hence it is a useful imaging modality for early rectal cancer. Magnetic resonance imaging (MRI) is useful for assessing the mesorectum and the mesorectal fascia which has useful prognostic significance and for early identification of local recurrence. Computerized tomography (CT) of the chest, abdomen and pelvis is used to rule out distant metastasis. Identification of the malignant nodes using EUS, CT and MRI is based on the size, morphology and internal characteristics but has drawbacks. Most of the common imaging techniques are suboptimal for imaging following chemoradiation as they struggle to differentiate fibrotic changes and tumor. In this situation, EUS and MRI may provide complementary information to decide further treatment. The article summarize indications, advantages and pitfalls of each imaging method. |