POTENTIAL OF ULTRASOUND EXAMINATION WITH ELASTOGRAPHY IN THE DIAGNOSIS OF RECTAL CANCER AND ITS RECURRENCE

 

Sandalevskaya A.G., Minko B.A., Zhabina R.M., Korytova L.I.

Russian Scientific Center of Radiology and Surgical Technologies. Department of cancer radiotherapy.

St. Petersburg, Russia.

Purpose. To assess the potential of ultrasound method with the use of sonoelstography in diagnosis of a rectal cancer (RC) and its recurrence in all stages during the combined treatment.

Material and methods. Ninety two patients with the stated diagnosis of rectal cancer were included in the study. 32 males and 60 females were examined at the age from 27 to 83 years, average age was 52,±6,8 years. Three groups of patients were selected: 32 patients with a primary rectal cancer, 40 patients with a recurrence after surgical treatment and 20 patients after surgeries who underwent chemoradiotherapy and who did not have any recurrence. All the patients underwent the complex ultrasound examination (USE) with elastography according to a certain protocol. The task of the ultrasound examination was to reveal and to detect the site of pathologic neoplasm, to assess its size and structure, rate of tumor invasion into the wall considering its layer structure, possible inclusion of a peritoneum in the tumorous process, pararectal fat tissues and organs of the small pelvis that are adjacent with a rectum. Special attention was paid to a detection of possible recurrence. A state of anastomosis, postoperated bed and surrounding tissues was assessed in operated patients.

Results. Ultrasound semiotics of RC was presented with an availability of the pathologic area of the rectum with typical signs of malignant process: walls thickening, decrease of their echogenicity and damage of their layer structure. When the recurrence was inside the rectum the same ultrasound signs were observed as in a primary rectum lesion. When recurrences were located outside the rectum in all the cases the recurrence was featured as hypoechogenic nodal mass with a heterogeneous structure. In all cases during the assessment of the revealed mass by means of the method of moved-wave elastography we received mapping with red colour that corresponded to a higher rigidity of neoplasm as compared to surrounding tissues and it was a sign of malignancy process. Furthermore, digital value of the rigidity was within the large range (from 25kPa to 238 kPa), maximum difference ratio with surrounding tissues was 9 (Ratio=9).

Conclusion. Ultrasound examination added with sonoelastography is an effective method for the diagnosis of rectal cancer and its recurrences.

 

Keywords: recurrence, rectal cancer, ultrasound examination, elastography.

Corresponding author: Sandalevskaya A.G., 
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For citation: Sandalevskaya A.G., Minko B.A., Zhabina R.M., Korytova L.I. Potential of ultrasound examination with elastography in the diagnosis of rectal cancer and its recurrence. REJR. 2016; 6 (1): 73-82. doi: 10.18411/a-2016-008