Validation of pelvic magnetic resonance imaging as the method of choice to determine the distance to the anal margin in rectal cancer

• Published in: Cirugia española (English ed.) 2022-12, Vol.100 (12), p.772-779
• Main Authors: Lorenzo Liñán, Miguel Ángel, García Armengol, Juan, Martín Martín, Gonzalo Pablo, Martínez Sanjuán, Vicente, Roig Vila, José Vicente
• Format: Article
• Language: English
• Subjects: Colonoscopia; Colonoscopy; Cáncer de recto; Distance to anal verge; Distancia al margen anal; Pelvic magnetic resonance imaging; Peritoneal anterior reflection; Rectal cancer; Rectosigmoidoscopia rígida; Reflexión peritoneal anterior; Resonancia magnética pélvica; Rigid rectosigmoidoscopy
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2022.08.015

[Display omitted] Distance from anal verge of rectal tumors and their anatomical relationships contribute to determine the multidisciplinary therapeutic strategy based on the combination of radio-chemotherapy and radical surgery. Our aims are to investigate which is the most accurate method for the preoperative measuring of the distance from the anal verge in rectal tumors and if the pelvic MRI can substitute the classical instrumental methods. Prospective study of diagnostic precision between flexible colonoscopy (FC), preoperative rigid rectosigmoidoscopy (pRR) and pelvic MRI in patients scheduled to radical surgery. Rigid intraoperative rectoscopy (iRR) was considered the reference test. The correlations between the different techniques and their determination coefficient as well as the intraclass correlation coefficient and the degree of agreement between the different tests were analyzed. 96 patients (65% males), mean age (SD): 68 (14.1) years were included. 72% received neoadjuvant treatment. The mean distance to the anal margin measured by FC = 103.5 mm, was significantly greater than others, which had similar values: pRR = 81.1; MRI = 77.4; iRR = 82.9 mm (P