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Can Ultrasound Elastography Discriminate between Rectal Adenoma and Cancer? A Systematic Review

SIMPLE SUMMARY: It is important to obtain correct preoperative classification of rectal polyps and cancer prior to making treatment decisions but distinguishing between the two can be challenging. International societies recommend magnetic resonance imaging and endorectal ultrasound as part of the i...

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Autores principales: Loft, Martina Kastrup, Pedersen, Malene Roland Vils, Rahr, Hans Bjarke, Rafaelsen, Søren Rafael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8391413/
https://www.ncbi.nlm.nih.gov/pubmed/34439313
http://dx.doi.org/10.3390/cancers13164158
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author Loft, Martina Kastrup
Pedersen, Malene Roland Vils
Rahr, Hans Bjarke
Rafaelsen, Søren Rafael
author_facet Loft, Martina Kastrup
Pedersen, Malene Roland Vils
Rahr, Hans Bjarke
Rafaelsen, Søren Rafael
author_sort Loft, Martina Kastrup
collection PubMed
description SIMPLE SUMMARY: It is important to obtain correct preoperative classification of rectal polyps and cancer prior to making treatment decisions but distinguishing between the two can be challenging. International societies recommend magnetic resonance imaging and endorectal ultrasound as part of the initial preoperative evaluation. The ultrasound examination can be improved by applying a tissue stiffness measurement, known as elastography. Our aim was to investigate the performance of elastography in the staging of rectal tumors. We systematically searched the literature and found six eligible studies. They all reported increased accuracy by elastography compared with ultrasound examination alone. ABSTRACT: Background: Rectal cancer is a common malignancy. Since the introduction of bowel-screening programs, the number of patients with advanced adenomas and early rectal cancer has increased. Despite improved diagnostics, the discrimination between rectal adenomas and early rectal cancer (i.e., pT1–T2) remains challenging. The purpose of this systematic review was to evaluate the diagnostic performance of endorectal ultrasound (ERUS) elastography in discriminating rectal adenomas from cancer. Method: Using PRISMA guidelines, a systematic search was performed on PubMed, Embase, and MEDLINE databases. Studies evaluating the primary staging of rectal adenomas and cancer using ERUS elastography were included. Results: Six studies were identified; three evaluated the discrimination between adenomas and cancer; two evaluated adenomas and early rectal cancer (i.e., pT1–T2); one evaluated performance on different T categories. All studies reported increased diagnostic accuracy of ERUS elastography compared to ERUS. Sensitivity, specificity and accuracy ranged 0.93–1.00, 0.83–1.00 and 0.91–1.00, respectively, when discriminating adenomas from cancer. In the differentiation between adenomas and early rectal cancer, the sensitivity, specificity and accuracy were 0.82–1.00, 0.86–1.00 and 0.84–1.00, respectively. Conclusion: Elastography increases the accuracy of ERUS and may provide valuable information on malignant transformation of rectal lesions.
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spelling pubmed-83914132021-08-28 Can Ultrasound Elastography Discriminate between Rectal Adenoma and Cancer? A Systematic Review Loft, Martina Kastrup Pedersen, Malene Roland Vils Rahr, Hans Bjarke Rafaelsen, Søren Rafael Cancers (Basel) Systematic Review SIMPLE SUMMARY: It is important to obtain correct preoperative classification of rectal polyps and cancer prior to making treatment decisions but distinguishing between the two can be challenging. International societies recommend magnetic resonance imaging and endorectal ultrasound as part of the initial preoperative evaluation. The ultrasound examination can be improved by applying a tissue stiffness measurement, known as elastography. Our aim was to investigate the performance of elastography in the staging of rectal tumors. We systematically searched the literature and found six eligible studies. They all reported increased accuracy by elastography compared with ultrasound examination alone. ABSTRACT: Background: Rectal cancer is a common malignancy. Since the introduction of bowel-screening programs, the number of patients with advanced adenomas and early rectal cancer has increased. Despite improved diagnostics, the discrimination between rectal adenomas and early rectal cancer (i.e., pT1–T2) remains challenging. The purpose of this systematic review was to evaluate the diagnostic performance of endorectal ultrasound (ERUS) elastography in discriminating rectal adenomas from cancer. Method: Using PRISMA guidelines, a systematic search was performed on PubMed, Embase, and MEDLINE databases. Studies evaluating the primary staging of rectal adenomas and cancer using ERUS elastography were included. Results: Six studies were identified; three evaluated the discrimination between adenomas and cancer; two evaluated adenomas and early rectal cancer (i.e., pT1–T2); one evaluated performance on different T categories. All studies reported increased diagnostic accuracy of ERUS elastography compared to ERUS. Sensitivity, specificity and accuracy ranged 0.93–1.00, 0.83–1.00 and 0.91–1.00, respectively, when discriminating adenomas from cancer. In the differentiation between adenomas and early rectal cancer, the sensitivity, specificity and accuracy were 0.82–1.00, 0.86–1.00 and 0.84–1.00, respectively. Conclusion: Elastography increases the accuracy of ERUS and may provide valuable information on malignant transformation of rectal lesions. MDPI 2021-08-18 /pmc/articles/PMC8391413/ /pubmed/34439313 http://dx.doi.org/10.3390/cancers13164158 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Loft, Martina Kastrup
Pedersen, Malene Roland Vils
Rahr, Hans Bjarke
Rafaelsen, Søren Rafael
Can Ultrasound Elastography Discriminate between Rectal Adenoma and Cancer? A Systematic Review
title Can Ultrasound Elastography Discriminate between Rectal Adenoma and Cancer? A Systematic Review
title_full Can Ultrasound Elastography Discriminate between Rectal Adenoma and Cancer? A Systematic Review
title_fullStr Can Ultrasound Elastography Discriminate between Rectal Adenoma and Cancer? A Systematic Review
title_full_unstemmed Can Ultrasound Elastography Discriminate between Rectal Adenoma and Cancer? A Systematic Review
title_short Can Ultrasound Elastography Discriminate between Rectal Adenoma and Cancer? A Systematic Review
title_sort can ultrasound elastography discriminate between rectal adenoma and cancer? a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8391413/
https://www.ncbi.nlm.nih.gov/pubmed/34439313
http://dx.doi.org/10.3390/cancers13164158
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