[Magnetic Resonance Imaging in the preoperative staging of XXXX ].

@entity188 @entity1 @entity5
INTRODUCTION: The treatment of @entity188 depends on the @entity5 stage, and until 2005 treatment included preoperative radiation therapy for the T3 and T4 @entity5 stages. An exact preoperative assessment of the @entity5 stage is therefore essential. In Denmark rectal Magnetic Resonance Imaging (MRI) is used as a standard procedure in preoperative evaluation, sometimes supplemented by transrectal ultrasound (TRUS). The purpose of this study was to determine the accuracy of preoperative MRI in @entity5 stage evaluation in order to correctly select the @entity1 who will benefit from preoperative radiation therapy. MATERIAL AND METHODS: The MRI reports from 173 @entity1 (98 male, 75 female, mean age 71 years) who underwent surgery for @entity188 at Hvidovre Hospital, Copenhagen during the 2002-2005-period were evaluated. The T-stage of the MRI report was compared to the histological T-stage of the resected @entity5 . RESULTS: The overall accuracy of @entity5 was 58% (n = 100) of which 41% T2 @entity5 (n = 18), 78% T3 @entity5 (n = 78) and 33% T4 @entity5 (n = 4) were correctly staged. In all, 29% of @entity5 were overstaged (n = 50) (100% of T1 @entity5 , 59% of T2 @entity5 , 7% of T3 @entity5 ). A total of 13% of the @entity5 were understaged (15% of T3 @entity5 , 67% of T4 @entity5 ). The selection of @entity1 for preoperative radiation therapy had a sensitivity and specificity of 83% and 48%, respectively. CONCLUSION: The overall accuracy of 58% indicates that MR imaging in the early learning phases was not an optimal method for the preoperative @entity5 . In particular, the low specificity of MRI in selecting the @entity1 who will benefit from preoperative radiation can result in overtreatment and increased morbidity.
