078ec194acd1e6ca4300111b3b7bca19 pmc_10855339.pdf 57a7ee0eebb551bdcbbbe3f964c7220437bbfd63 pmc_10855339.pdf c904bbe9ce3517f557fc6c7bac467a2eed65001f4d0285a98d35cfffd4ce2212 pmc_10855339.pdf Title: How to Study the Location and Size of Rectal Tumors That Are Candidates for Local Surgery: Rigid Rectoscopy, Magnetic Resonance, Endorectal Ultrasound or Colonoscopy? An Interobservational Study Subject: 1. Background. Preoperative staging of rectal lesions for transanal endoscopic surgery (TES) comprises digital rectal examination, intraoperative rigid rectoscopy (IRR), endorectal ultrasound (EUS), colonoscopy and rectal magnetic resonance imaging (rMRI). The gold standard for topographic features is IRR. Are the results of the other tests sufficiently reliable to eliminate the need for IRR? rMRI is a key test in advanced rectal cancer and is not operator-dependent. Description of anatomical landmarks is variable. Can we rely on the information regarding topographic features provided by all radiologists? 2. Materials and Methods. This is a concordance interobservational study involving four diagnostic tests of anatomical characteristics of rectal lesions (colonoscopy, EUS, rectal MRI and IRR), performed by four expert radiologists, regarding topographic rectal features with rMRI. 3. Results. Fifty-five rectal tumors were operated on by using TES. The distance of the tumor from the anal verge, location by quadrants, size by quadrants and size of tumor were assessed (IRR as gold standard). For most of the tumors, the correlation between IRR and colonoscopy or EUS was very good (ICC > 0.75); the correlation between rMRI and IRR in respect of the size by quadrants (ICC = 0.092) and location by quadrants (ICC = 0.292) was weak. Topographic landmarks studied by the expert radiologists had an excellent correlation, except for distance from the peritoneal reflection to the anal verge (ICC = 0.606). 4. Conclusions. Anatomical description of rectal lesions by IRR, EUS, colonoscopy and rMRI is reliable. Topographic data obtained by EUS and colonoscopy can serve as a reference to avoid IRR. Determination of these topographic data by rMRI is less reliable. As performed by the expert radiologists, the anatomical study by rMRI is accurate and reproducible. Keywords: rectal tumors; rectal MRI; local surgery Author: Anna Serracant, Beatriz Consola, Eva Ballesteros, Marta Sola, Francesc Novell, Noemi Montes and Xavier Serra-Aracil Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Wed Jan 31 15:44:51 2024 CET ModDate: Wed Jan 31 15:50:24 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 9 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 518376 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- XCAPSF+URWPalladioL-Bold Type 1 Custom yes yes yes 10 0 HJTPHL+URWPalladioL-Roma Type 1 Custom yes yes yes 16 0 QMKFHP+URWPalladioL-Ital Type 1 Custom yes yes yes 21 0 CIQLLF+VnURWPalladioL Type 1 Custom yes yes yes 26 0 BXZUUH+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 43 0 MJOHHP+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 66 0 MJOHJP+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 72 0 MJOIBN+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 78 0 MJOIBO+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 84 0 MJOIBP+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 87 0 MJOICA+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 90 0 MJOIFA+PalatinoLinotype-Roman TrueType MacRoman yes yes no 93 0 URYLRZ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 100 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-03-15 02:41:34 CET RepresentationInformation: pmc_10855339.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-02-21 02:32:07 CET Size: 518376 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 232 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design Destination: subsection.2.1 Item: Title: Patients and Settings Destination: subsection.2.2 Item: Title: Inclusion Criteria Destination: subsection.2.3 Item: Title: Exclusion Criteria Destination: subsection.2.4 Item: Title: Preoperative Preparation, Surgical Technique Destination: subsection.2.5 Item: Title: Study Variables Destination: subsection.2.6 Item: Title: Statistical Analysis Destination: subsection.2.7 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Limitations of This Study/Future Directions Destination: section.5 Item: Title: Conclusions Destination: section.6 Item: Title: References Destination: section.7 Info: Title: How to Study the Location and Size of Rectal Tumors That Are Candidates for Local Surgery: Rigid Rectoscopy, Magnetic Resonance, Endorectal Ultrasound or Colonoscopy? An Interobservational Study Author: Anna Serracant, Beatriz Consola, Eva Ballesteros, Marta Sola, Francesc Novell, Noemi Montes and Xavier Serra-Aracil Subject: 1. Background. Preoperative staging of rectal lesions for transanal endoscopic surgery (TES) comprises digital rectal examination, intraoperative rigid rectoscopy (IRR), endorectal ultrasound (EUS), colonoscopy and rectal magnetic resonance imaging (rMRI). The gold standard for topographic features is IRR. Are the results of the other tests sufficiently reliable to eliminate the need for IRR? rMRI is a key test in advanced rectal cancer and is not operator-dependent. Description of anatomical landmarks is variable. Can we rely on the information regarding topographic features provided by all radiologists? 2. Materials and Methods. This is a concordance interobservational study involving four diagnostic tests of anatomical characteristics of rectal lesions (colonoscopy, EUS, rectal MRI and IRR), performed by four expert radiologists, regarding topographic rectal features with rMRI. 3. Results. Fifty-five rectal tumors were operated on by using TES. The distance of the tumor from the anal verge, location by quadrants, size by quadrants and size of tumor were assessed (IRR as gold standard). For most of the tumors, the correlation between IRR and colonoscopy or EUS was very good (ICC > 0.75); the correlation between rMRI and IRR in respect of the size by quadrants (ICC = 0.092) and location by quadrants (ICC = 0.292) was weak. Topographic landmarks studied by the expert radiologists had an excellent correlation, except for distance from the peritoneal reflection to the anal verge (ICC = 0.606). 4. Conclusions. Anatomical description of rectal lesions by IRR, EUS, colonoscopy and rMRI is reliable. Topographic data obtained by EUS and colonoscopy can serve as a reference to avoid IRR. Determination of these topographic data by rMRI is less reliable. As performed by the expert radiologists, the anatomical study by rMRI is accurate and reproducible. 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