CT Evaluation of Rectal Carcinoma with Histopathological Correlation

Abstract

Colorectal cancer is a major cause of death from cancer in many countries. Computed tomographic (CT) scanning has been suggested as an aid to assess the extension of involvement, spread and staging of carcinoma rectum. A cross-sectional observational study was carried out to correlate the CT findings of rectal carcinoma with histopathological parameters. The study was conducted in collaboration with the Department of Radiology & Imaging and the Department of Colorectal Surgery, BSMMU, Dhaka. 50 patients were selected purposively among the admitted in the department of colorectal surgery having clinical diagnosis of rectal carcinoma during the period of July 2007 to April 2009. Verbal consent was taken from each patient. Multi slice CT of abdomen was performed after counseling the patients. Oral, per rectal and intravenous contrast was used for imaging. The postoperative resected tissue was sent for histopathological examination. Data were collected in a predesigned and pre tested data collection sheet and analyzed using windows for SPSS. It was found that the CT findings were correlated well with the histopathological parameters. The present study showed, CT scan could detect rectal growth in 17 (34%) cases, rectosigmoid growth in 2 (4%) cases. It helped staging rectal cancer. T1M0N0 and T2M1N0 detected by CT scan were found in 3 (6%) cases in each group, T2M0N0 and T3M0N0 found in 23 (46%) cases and 2 (4%) cases respectively. Histopathological finding revealed all growth as cancer. It gave variations of differentiation. The sensitivity, accuracy, positive predictive value o were 100%. Histopathological examination revealed adenocarcinoma in majority cases (86%). Anaplastic squamous cell carcinoma and poorly
differentiated adenocarcinoma were found in 2 (4%) cases in each group. Metaplastic change and signet-ring type lesion were observed in 1(2%) of cases.