Multi-detector row CT has high accuracy for colon cancer staging.

1. M Scott, R Sinha, S Saunders, J Francombe Warwick GI Unit, South Warwickshire NHS Trust, Warwick South Warwickshire NHS Trust Efficacy of CT in the preoperative staging of colon cancer: comparison of multi-planar and axial images with histopathology Introduction Methods • MRI is the gold standard for rectal cancer staging and provides useful information which guides neo-adjuvant treatment. Most UK centres use CT for colon cancer staging, primarily aiming to identify distant metastases. • Depth of tumour invasion (T) and regional lymph node involvement (N) were evaluated on axial images alone and in combination with multi-planar reconstructions (MPR’s). • CT findings were compared with subsequent histopathology results. Aim Results • Thirty patients (13F:17M) mean age 72.5yrs • In T staging overall accuracy was 46.6% for axial images alone. This improved to 80% in combination with MPR’s (p<0.01). • Nodal status was 72.4% accurate for axial images alone and 80% in combination with MPR’s. • MPR allowed 100% accurate identification of T3/T4 tumours • The sensitivity and specificity of MPR’s for nodal disease was 100% and 70% respectively. • To assess the efficacy of contrast-enhanced multi-detector row CT imaging in the staging of colorectal cancer. AXIAL MPR Diagnostic accuracy of stage (%) Chi sq 7.2 p<0.01 Diagnostic accuracy of nodal status (%) Chi sq 0.88 p=0.6 Conclusions • Multi-detector row CT has high accuracy for colon cancer staging. • Addition of multi-planar images to standard axial images provides higher accuracy rates for both T and N staging. • Improved preoperative staging enables better prognostic prediction and may allow selected patients to be considered for neo-adjuvant • treatment.