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  • Key words: Endorectal ultrasound — Three-dimensional endorectal ultrasound — Rectal cancer — Staging — Endorectal MR imaging — Surface coil — Cancer  (1)
  • Key words: Endoscopic ultrasound — Curved array — Staging — Endosonography-guided biopsy  (1)
  • Key words: Rectal cancer — Preoperative staging — Endorectal ultrasound — Preoperative radiochemotherapy  (1)
  • Three-dimensional imaging  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Three-dimensional endorectal ultrasonography for staging of obstructing rectal cancer (1996)
    Springer
    Diseases of the colon & rectum 39 (1996), S. 636-642 
    Details
    ISSN: 1530-0358
    Keywords: Three-dimensional imaging ; Endorectal ultrasonography ; Rectal cancer ; Stenosis ; Preoperative staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Preoperative staging of advanced carcinoma of the rectum by conventional endorectal ultrasonography is often impossible because of the presence of obstruction, which does not allow passage of the endoprobe. In a prospective Study, we investigated the value of three-dimensional endorectal ultrasonography for staging of obstructing rectal cancer. This technique permits examination of obstructing rectal tumors because scan planes can be chosen deliberately within a scanned volume. METHODS: Overall obstructing tumors not accessible for conventional endoprobes were found in 26 of 94 patients who were subjected to endorectal ultrasonography for staging of rectal cancer. Three-dimensional volume scanning was performed using a three-dimensional frontfire transducer or a three-dimensional bifocal multiplane transducer (7.5/10 MHz). Data of the three-dimensional scans were stored on a hard disk for subsequent evaluation with a combison 530 processor. RESULTS: Three-dimensional transrectal endosonography enabled visualization of local tumor spread in all 26 patients. In 18 patients, obstruction was caused by advanced primary rectal carcinoma. Endosonography accurately determined the tumor infiltration depth in three T2 tumors, eight T3 tumors, and three T4 tumors. Overall accuracy for assessment of infiltration depth was 78 percent. Accuracy for assessment of perirectal lymph node involvement was 75 percent. In eight patients, the obstruction was attributable to extramural regrowth of rectal cancer after surgery. Diameter of the lesions ranged between 3 and 6 cm. Although all lesions were clearly depicted by three-dimensional endosonography, only five lesions (62 percent) were detected by computed tomography. CONCLUSIONS: Three-dimensional endorectal ultrasonography provides previously unattainable scan planes and enables accurate staging of obstructing rectal tumors. This technique may improve therapy planning in advanced rectal cancer by selecting patients who require preoperative adjuvant therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02056942
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Endosonography and endosonography-guided biopsy of upper-GI-tract tumors using a curved-array echoendoscope (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1205-1209 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endoscopic ultrasound — Curved array — Staging — Endosonography-guided biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The purpose of the present study was to evaluate the accuracy of endoscopic ultrasonography (EUS) with a curved-array transducer and to determine the value of endosonography-guided biopsy. Methods: EUS was performed in 162 consecutive patients for preoperative staging of gastric or esophageal cancer (n= 122) or for EUS-guided biopsy (n= 40). All patients were examined using a flexible echoendoscope (Pentax FG32-UA) equipped with a 7.5-MHz curved-array transducer. A specially designed fine needle was used for EUS-guided biopsy of submucosal or extrinsic lesions. Results: Surgery was performed in 19 of 48 patients with esophageal cancer and 60 of 74 patients with gastric cancer. The accuracy in the assessment of the infiltration depth of esophageal cancer and in the determination of lymph node involvement was 84% and 88%, respectively. In gastric cancer the tumor infiltration depth was assessed correctly in only 65% of the patients. The identification of early gastric cancer proved to be a major problem. The accuracy in the detection of lymph node involvement was 73%. Obstructing tumors were examined in 17 patients with carcinoma of the esophagus or the gastric cardia. The accuracy of EUS in determining the T-stage and the N-stage of stenotic tumors was 88% and 86%, respectively. Endosonography-guided needle biopsy was successfully performed in all 40 patients. Histologic analysis revealed malignancy in 50% of the patients. Only two biopsy specimens contained nonrepresentative material (accuracy: 95%). No complications were observed related to the procedure. Conclusions: EUS with a curved-array transducer provides high accuracy rates in staging of esophageal carcinoma. Evaluation of gastric cancer with this technique appears to be more difficult than with radial transducers. A major advantage of the linear transducer is the ability to perform EUS-guided biopsies of submucosal or extamural lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900280
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Accuracy of endorectal ultrasound after preoperative radiochemotherapy in locally advanced rectal cancer (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 980-984 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Rectal cancer — Preoperative staging — Endorectal ultrasound — Preoperative radiochemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: Factors limiting the accuracy of endorectal ultrasound in staging, locally advanced primary rectal cancer after preoperative neoadjuvant radiochemotherapy (RCT) were evaluated. Methods: Patients (n= 84) with initial locally advanced rectal cancer (uT3/uT4) undergoing R0 resection were investigated after preoperative treatment that combined radiotherapy up to 45 Gy with two cycles of chemotherapy (5-FU and leucovorin on d 1–5 and 22–28). At 4 to 6 weeks after completion of RCT and before tumor resection, preoperative endoluminal ultrasound was performed. Results: The accuracy to predict the depth of tumor infiltration (T-category) was found to correlate with downstaging. The T-category was correctly staged before surgery in 15 of the 51 responders (29%) and in 27 of 33 nonresponders (82%), whereas misinterpretation occurred in 36 of the responders (71%) and in 6 of the nonresponders (18%) (p 〈 0.001). Neither tumor distance from anal verge nor tumor location correlated with the staging accuracy. Lymph node involvement was correctly assessed in 48 patients (57%). Wall invasion was correctly ascertained in 42 patients (50%), with under estimation in 11 patients (13%) and overestimation in 31 patients (37%). Conclusions: After radiochemotherapy, endosonography does not provide a satisfactory accuracy for preoperative staging of rectal cancer. New interpretation and diagnostic criteria are needed for the prediction of treatment response.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649901151
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Prospective comparison of endorectal ultrasound, three-dimensional endorectal ultrasound, and endorectal MRI in the preoperative evaluation of rectal tumorsrid="" (2000)
    Springer
    Surgical endoscopy and other interventional techniques 14 (2000), S. 1005 -1009 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endorectal ultrasound — Three-dimensional endorectal ultrasound — Rectal cancer — Staging — Endorectal MR imaging — Surface coil — Cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The aim of this study was to compare the value of endorectal ultrasound (EUS), three-dimensional (3D) EUS, and endorectal MRI in the preoperative staging of rectal neoplasms. Methods: Thirty consecutive patients with rectal tumors were assessed by EUS and endorectal MRI. Additionally, three-dimensional ultrasound was performed in a subgroup of 25 patients. EUS data were obtained with a bifocal multiplane transducer (10 MHz) and processed on a 3D ultrasound workstation. MR imaging was carried out with a 1.5 T superconducting unit using an endorectal surface coil. Results: EUS was carried out successfully in all 30 patients, whereas endorectal MRI was not feasible in two patients. Compared with the histopathological classification, EUS and endorectal MRI correctly determined the tumor infiltration depth in 25 of 30 and 28 patients, respectively. The comparative accuracy of EUS, 3D EUS, and endorectal MRI in predicting tumor invasion was 84%, 88%, and 91%, respectively. EUS, three-dimensional EUS, and endorectal MRI enabled us to assess the lymph node status correctly in 25, 25, and 24 patients, respectively. Both three-dimensional EUS and endorectal MRI combined high-resolution imaging and multiplanar display options. Assessment of additional scan planes facilitated the interpretation of the findings and improved the understanding of the three-dimensional anatomy. Conclusion: The accuracy of three-dimensional EUS and endorectal MRI in the assessment of the infiltration depth of rectal cancer is comparable to conventional EUS. One advantage of both methods is the ability to obtain multiplanar images, which may be helpful for the planning of surgery in the future.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004640000345
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    Paper (German National Licenses)
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