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Imaging strategies for rectal cancer initial staging: does pelvic Computed Tomography provide significantly additional findings when high-resolution Magnetic Resonance Imaging has been performed


Li-Yan Liu and Liheng Liu*  


Background: Initial staging for rectal cancer is based on high-resolution magnetic resonance imaging (MRI), but pelvic computed tomography (CT) is also frequently used as well. We aimed to evaluate the added clinical benefit of pelvic CT or whether it can alter the initial staging or not.

Methods: The study was composed of 187 patients with rectal cancer. First, imaging except pelvic CT was evaluated. Second, the pelvic CT was evaluated and the staging was adjusted according to the new findings. Subsequently, the two staging results were compared to investigate the added clinical benefit of pelvic CT.

Results: Compared with imaging data except pelvic CT, new findings showed by pelvic CT included metastases of pelvic bone (n = 1) and pelvic peritoneum (n = 3). However the new findings did not change the primary staging. Of the three patients with pelvic peritoneal metastasis, two were already determined as with peritoneal involvement and ascites by abdominal CT, and the third patient was found with liver and distant lymph node metastasis. Thus none of their initial staging need changed.

Conclusions: The addition of pelvic CT to the pre-treatment imaging strategy cannot provide added clinical benefit for primary evaluation of rectal cancer.


Rectal cancer, diagnosis, magnetic resonance imaging, computed tomography


Department of Radiology, Tengzhou Maternal and Child Health Hospital, Tengzhou Children’s Hospital, Department of Radiology, Zhongshan Hospital, Fudan University

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