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. 2006 Oct 18:3:36.
doi: 10.1186/1477-7800-3-36.

The role of endoscopic ultrasound in the evaluation of rectal cancer

Ali A Siddiqui  1 , Yomi Fayiga, Sergio Huerta
Affiliations

The role of endoscopic ultrasound in the evaluation of rectal cancer

Ali A Siddiqui et al. Int Semin Surg Oncol. .

Abstract

Accurate staging of rectal cancer is essential for selecting patients who can undergo sphincter-preserving surgery. It may also identify patients who could benefit from neoadjuvant therapy. Clinical staging is usually accomplished using a combination of physical examination, CT scanning, MRI and endoscopic ultrasound (EUS). Transrectal EUS is increasingly being used for locoregional staging of rectal cancer. The accuracy of EUS for the T staging of rectal carcinoma ranges from 80-95% compared with CT (65-75%) and MR imaging (75-85%). In comparison to CT, EUS can potentially upstage patients, making them eligible for neoadjuvant treatment. The accuracy to determine metastatic nodal involvement by EUS is approximately 70-75% compared with CT (55-65%) and MR imaging (60-70%). EUS guided FNA may be beneficial in patients who appear to have early T stage disease and suspicious peri-iliac lymphadenopathy to exclude metastatic disease.

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Figures

Figure 1
Figure 1
Correlation between the standard five EUS layers and histological layers of the normal intestinal wall. 1st = interface between fluid in the lumen and the superficial mucosa; 2nd = lamina propria and muscularis mucosa, or deep mucosa; 3rd = submucosa and interface between submucosa and muscularis propria; 4th = muscularis propria; circular (4a) and longitudinal (4c) are not usually seen as separate layers; 5th = interface between serosa and surrounding adventitial tissue.
Figure 2
Figure 2
EUS image of T1 rectal cancer confined to mucosa and superficial submucosa. SM=submucosa, MP=muscularis propria, SR=serosa.
Figure 3
Figure 3
EUS image of T2 rectal cancer invading the muscularis propria.
Figure 4
Figure 4
EUS image of T4 rectal cancer with a metastasis to a perirectal lymph node (L).
See this image and copyright information in PMC

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