А.V. Usova1, I.G. Frolova1, S.G. Afanasyev1, А.S. Tarasova1, I.B. Khadagaev2, S.А. Fursov3, Е.А. Usynin1, N.G. Trukhacheva1, Е.G. Grigoriev1, А.Yu. Dobrodeev1
1Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk
2Novosibirsk Regional Clinical Cancer Center, Novosibirsk
3A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow
Afanasyev S.G. ― D. Sc. (Medicine), Professor, Head of the Department of Abdominal Oncology of Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences
5 Kooperativny Lane, Tomsk, Russian Federation, 634009, tel. (3822) 41-80-89, e-mail: Afanasievsg@oncology.tomsk.ru, SPIN-код: 9206-3037, ORCID ID: 0000-0002-4701-0375
Abstract
Background. Tumors affecting the distal parts of the digestive tract are characterized by frequent damages to adjacent organs. For planning extensive surgical treatment, a detailed assessment of the local extent of the tumor is extremely important.
The purpose of the study was to evaluate the role of diffusion-weighted and dynamic contrast enhanced MRI in planning multivisceral resections in patients with locally advanced rectal and sigmoid cancers.
Material and methods. The study included the results of preoperative examination and surgical treatment of 27 patients with rectal and sigmoid adenocarcinoma invaded into organs of the pelvis. All patients were examined using 1.5-Tessla equipment (MAGNETOM ESSENZA, Siemens) with the Body Matrix surface phased coil.
Results. Preoperative examination showed tumor invasion into one adjacent organ in 12 (44.4%) patients and into two and more organs in 15 (55.6%) patients. Tumor invasion into the bladder was the most common (59.3%) followed by invasion into the uterine edometrium or cervix (37.0%). Total evisceration of the pelvis was performed in 2 (7.4%) cases and combined resection of the rectum and resection of the adjacent organs was performed in 25 (92.3%) cases. Urinary tract resection was performed most often (20 patients, 74.1%). Histological examination confirmed tumor invasion into adjacent organs in 23 (85.2%) patients. Paratumoral inflammatory infiltrate was diagnosed in 4 (14.8%) patients. Conclusion. Magnetic resonance imaging with the analysis of «standard» MRI-scans and the assessment of dynamic and diffuse MRI findings is a useful tool for the detection of the local extent of rectal and sigmoid cancers as well as for planning multivisceral resections of organs of the pelvis.
Key words: rectal cancer, sigmoid cancer, multivisceral resections, preoperative diagnosis, magnetic resonance imaging.