Contrast Enhanced Helical Multidetector Computerized Tomography (MDCT): Is it still useful for Diagnosis and Staging of Colorectal Carcinoma?

Abstract

Purpose: To assess the capability of contrast enhanced multidetector computed tomography helical (MDCT) for the diagnosis, local spread, lymph nodal involvement and metastatic staging of colorectal carcinoma.

Subject and methods:

Over a period of 18 months, 72 patients who were refered for contrast enhanced MDCT with a clinical suspicion of colorectal Ca followed by optical colonoscopy with biopsy and/or surgery for the treatment of colorectal carcinoma were included in this study.

Results:

MDCT showed sensitivity and specificity of 77.35% and 78.94% for the detection of tumor. For local spread MDCT displayed high specificity 84.61 % and sensitivity 75% when compared with operative findings. MDCT was equally sensitive and specific for the detection of lymphadenopathy i.e., 69.44% sensitive and 76.69% specific. For the diagnosis of hepatic metastasis MDCT has shown highest sensitivity of 90.90% and highest specificity of 96.77% when performed in arterial phase of CT scan.

Conclusion:  Although due to advancement in technology newer imaging modalities such as CT colonography, MRI and PET/CT are nowadays best modalities for the preoperative staging of colorectal carcinoma but due to its easy availability, cost-affordibility and better diagnostic accuracy MDCT is still an investigation of choice for suggesting diagnosis and deciding the operability of Colorectal Carcinoma in our country.

Key words: MDCT scan, colorectal carcinoma, preoperative, staging