Endorectal Ultrasound Shear-Wave Elastography of Complex Rectal Adenoma and Early Rectal Cancer
Purpose: To investigate the diagnostic performance of endorectal ultrasound (ERUS), shear-wave elastography (SWE), and magnetic resonance imaging (MRI) in patients with a complex rectal adenoma or an early rectal cancer, i.e., T1 or T2 adenocarcinoma in a clinical setting, and to evaluate the associ...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/9/2166 |
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| author | Martina Kastrup Loft Malene Roland Vils Pedersen Jan Lindebjerg Hans Bjarke Rahr Søren Rafael Rafaelsen |
| author_facet | Martina Kastrup Loft Malene Roland Vils Pedersen Jan Lindebjerg Hans Bjarke Rahr Søren Rafael Rafaelsen |
| author_sort | Martina Kastrup Loft |
| collection | DOAJ |
| description | Purpose: To investigate the diagnostic performance of endorectal ultrasound (ERUS), shear-wave elastography (SWE), and magnetic resonance imaging (MRI) in patients with a complex rectal adenoma or an early rectal cancer, i.e., T1 or T2 adenocarcinoma in a clinical setting, and to evaluate the association between SWE and stromal fraction (SF) and apparent diffusion coefficient (ADC) and SF. Method: This prospective study included patients undergoing ERUS and SWE for a rectal tumor subsequently confirmed by histopathology to be an adenoma or a T1 or T2 adenocarcinoma. The accuracy of the imaging methods was assessed by comparing the T category as determined by ERUS and MRI with histopathology, which served as the gold standard. SF was assessed on surgical specimens. Results: A total of 86 patients were included. Of these, 62 patients had adenomas and 24 patients had carcinomas, of which 11 were T1 tumors and 13 were T2 tumors. ERUS and MRI yielded sensitivity, specificity, and accuracy of 0.79 and 0.73, 0.95 and 0.90, and 0.86 and 0.78, respectively, for discrimination between benign and malignant lesions. The area under the receiver operating characteristics curve for SWE was 0.88, and with a cut-off value of 40 kPa the sensitivity, specificity, and accuracy were 0.79, 0.89, and 0.86, respectively. There was a positive correlation between SF and SWE with a <i>p</i>-value of <0.001 and a negative correlation between SF and ADC with a <i>p</i>-value of 0.011. Conclusion: Both ERUS and MRI classified T categories with a high accuracy; however, ERUS classified more adenomas correctly than MRI. In this small population, SWE could differentiate an adenoma from early carcinoma. SF was correlated with both SWE and ADC, as increasing SF tended to yield higher SWE and lower ADC values. |
| first_indexed | 2024-03-10T00:16:43Z |
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| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T00:16:43Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-2cb8053eac0949ffaaad6cf392ce05fa2023-11-23T15:49:47ZengMDPI AGDiagnostics2075-44182022-09-01129216610.3390/diagnostics12092166Endorectal Ultrasound Shear-Wave Elastography of Complex Rectal Adenoma and Early Rectal CancerMartina Kastrup Loft0Malene Roland Vils Pedersen1Jan Lindebjerg2Hans Bjarke Rahr3Søren Rafael Rafaelsen4Department of Radiology, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, DenmarkDepartment of Radiology, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, DenmarkDanish Colorectal Cancer Center South, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, DenmarkDepartment of Regional Health Research, University of Southern Denmark, Campusvej 55, 5000 Odense, DenmarkDepartment of Radiology, Vejle Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, DenmarkPurpose: To investigate the diagnostic performance of endorectal ultrasound (ERUS), shear-wave elastography (SWE), and magnetic resonance imaging (MRI) in patients with a complex rectal adenoma or an early rectal cancer, i.e., T1 or T2 adenocarcinoma in a clinical setting, and to evaluate the association between SWE and stromal fraction (SF) and apparent diffusion coefficient (ADC) and SF. Method: This prospective study included patients undergoing ERUS and SWE for a rectal tumor subsequently confirmed by histopathology to be an adenoma or a T1 or T2 adenocarcinoma. The accuracy of the imaging methods was assessed by comparing the T category as determined by ERUS and MRI with histopathology, which served as the gold standard. SF was assessed on surgical specimens. Results: A total of 86 patients were included. Of these, 62 patients had adenomas and 24 patients had carcinomas, of which 11 were T1 tumors and 13 were T2 tumors. ERUS and MRI yielded sensitivity, specificity, and accuracy of 0.79 and 0.73, 0.95 and 0.90, and 0.86 and 0.78, respectively, for discrimination between benign and malignant lesions. The area under the receiver operating characteristics curve for SWE was 0.88, and with a cut-off value of 40 kPa the sensitivity, specificity, and accuracy were 0.79, 0.89, and 0.86, respectively. There was a positive correlation between SF and SWE with a <i>p</i>-value of <0.001 and a negative correlation between SF and ADC with a <i>p</i>-value of 0.011. Conclusion: Both ERUS and MRI classified T categories with a high accuracy; however, ERUS classified more adenomas correctly than MRI. In this small population, SWE could differentiate an adenoma from early carcinoma. SF was correlated with both SWE and ADC, as increasing SF tended to yield higher SWE and lower ADC values.https://www.mdpi.com/2075-4418/12/9/2166endorectal ultrasoundshear-wave elastographydiffusion-weighted imagingmagnetic resonance imagingrectal cancerrectal adenoma |
| spellingShingle | Martina Kastrup Loft Malene Roland Vils Pedersen Jan Lindebjerg Hans Bjarke Rahr Søren Rafael Rafaelsen Endorectal Ultrasound Shear-Wave Elastography of Complex Rectal Adenoma and Early Rectal Cancer Diagnostics endorectal ultrasound shear-wave elastography diffusion-weighted imaging magnetic resonance imaging rectal cancer rectal adenoma |
| title | Endorectal Ultrasound Shear-Wave Elastography of Complex Rectal Adenoma and Early Rectal Cancer |
| title_full | Endorectal Ultrasound Shear-Wave Elastography of Complex Rectal Adenoma and Early Rectal Cancer |
| title_fullStr | Endorectal Ultrasound Shear-Wave Elastography of Complex Rectal Adenoma and Early Rectal Cancer |
| title_full_unstemmed | Endorectal Ultrasound Shear-Wave Elastography of Complex Rectal Adenoma and Early Rectal Cancer |
| title_short | Endorectal Ultrasound Shear-Wave Elastography of Complex Rectal Adenoma and Early Rectal Cancer |
| title_sort | endorectal ultrasound shear wave elastography of complex rectal adenoma and early rectal cancer |
| topic | endorectal ultrasound shear-wave elastography diffusion-weighted imaging magnetic resonance imaging rectal cancer rectal adenoma |
| url | https://www.mdpi.com/2075-4418/12/9/2166 |
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