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. 2025 May 5:11:a25696939.
doi: 10.1055/a-2569-6939. eCollection 2025.

Evaluating Extended Field of View Imaging for Measuring Rectal Tumor Lowest Boundary to Anal Verge Distance via Transrectal Biplane Ultrasound

Yan Zhang  1 , Lu Liang  2 , Huachong Ma  3 , Jiagang Han  3 , Xiuzhang Lv  1 , Huiyu Ge  1
Affiliations

Evaluating Extended Field of View Imaging for Measuring Rectal Tumor Lowest Boundary to Anal Verge Distance via Transrectal Biplane Ultrasound

Yan Zhang et al. Ultrasound Int Open. .

Abstract

Purpose: This study aimed to measure the precise distance from the lowest boundary of a rectal tumor to the anal verge (DTAV) in patients with rectal cancer.

Materials and methods: A retrospective analysis was performed on clinical data from 70 rectal cancer patients. DTAV measurements were collected using transrectal biplane ultrasound, MRI, and colonoscopy.

Results: The difference in DTAV measurements between the mean DTAV value obtained by ultrasound (US mean ) and colonoscopy exhibited a difference of 0.22 cm. In contrast, the difference between US mean and MRI was 0.48 cm, while the difference between MRI and colonoscopy was -0.26 cm. The ICC for DTAV measurements demonstrated excellent agreement, with values of 0.948 between US mean and MRI, 0.942 between US mean and colonoscopy, and 0.943 between MRI and colonoscopy. The minimum DTAV value obtained by ultrasound (US min ) was 5.05 cm, the middle DTAV value obtained by ultrasound (US mid ) was 5.10 cm, and the maximum DTAV value obtained by ultrasound (US max ) was 5.30 cm. Notably, the median values of the differences in DTAV measurements between US max and US min , US max and US mid , as well as US mid and US min , were 0.2 cm, 0.1 cm, and 0.1 cm, respectively. Furthermore, the consistency of DTAV measurements between US min and US mid , US max and US mid , as well as US min and US max was excellent, with all ICC values reaching 0.999. Additionally, the radiologist's reassessment of MRI DTAV data showed excellent consistency with the original results, with an ICC value of 0.985.

Conclusion: Transrectal biplane ultrasound utilizing EFOV imaging technology exhibited both accuracy and reproducibility for measuring DTAV. This approach provided a highly efficient and practical clinical tool for DTAV measurement.

Keywords: MR imaging; colonoscopy; extended field of view technology; rectal cancer; transrectal biplane ultrasound.

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Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
DTAV measurement is performed using EFOV imaging technology with an intracavitary biplane probe. The yellow line indicates the distance from the lowest boundary of the rectal tumor to the anal verge.
Fig. 2
Fig. 2
On sagittal T2-weighted MRI images, the DTAV is measured by tracing a yellow polyline along the rectal tract, and the cumulative length of this line is then used to determine the distance from the lowest margin of the rectal tumor to the anal verge.
Fig. 3
Fig. 3
Scatter plots highlighted the favorable consistency in pairwise comparisons of DTAV measurements derived from three distinct methods.
Fig. 4
Fig. 4
Bland-Altman plots highlighted the favorable consistency in pairwise comparisons of DTAV measurements derived from three distinct methods.
See this image and copyright information in PMC

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