Preoperative staging and planning for sphincter sparing surgery in rectal carcinoma using high resolution T2WI following endorectal gel administration

Purpose To assess the accuracy of high resolution T2WI with the addition of DWI in the preoperative staging, prediction of negative circumferential resection margin and planning of surgical management of rectal carcinoma. Patients and methods Seventy-five patients (30 men and 45 women) with pathologically proven rectal carcinoma underwent high resolution MRI study with trans-rectal gel administration. The MRI staging was compared with the postoperative pathological staging. Results The MRI Sensitivity was 98.63%, Specificity 97.3% and accuracy 97.96% in evaluation of T staging. For the assessment of lymph node involvement, the sensitivity was 98.18%, specificity 85.00%, and accuracy 94.67% in correlation with histopathological study. Conclusion High resolution MRI is accurate for preoperative staging, prediction of negative circumferential resection margin, lymph nodes involvement and planning the feasibility of sphincter-sparing surgery.