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Cited 7 time in webofscience Cited 7 time in scopus
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How to accurately measure the distance from the anal verge to rectal cancer on MRI: a prospective study using anal verge markers

Authors
Han, Yeo EunPark, Beom JinSung, Deuk JaeKim, Min JuHan, Na YeonSim, Ki ChoonCho, Sung BumKim, JinKim, Seon-HahnAn, Hyonggin
Issue Date
Feb-2021
Publisher
Springer New York
Keywords
Magnetic resonance imaging; Anal canal; Rectal cancer; Prospective studies; Sigmoidoscopy
Citation
Abdominal Radiology, v.46, no.2, pp 449 - 458
Pages
10
Indexed
SCIE
SCOPUS
Journal Title
Abdominal Radiology
Volume
46
Number
2
Start Page
449
End Page
458
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/33060
DOI
10.1007/s00261-020-02654-9
ISSN
2366-004X
2366-0058
Abstract
Purpose To determine an accurate method for localizing rectal cancer using the distance from the anal verge on preoperative MRI. Methods This prospective study included 50 patients scheduled for MRI evaluation of rectal cancer. After rectal filling with gel, MRI was performed with two markers attached at the anal verge. The distance between the tumor and the anal verge on a sagittal T2-weighted image (T2WI) was measured independently by two radiologists using six methods divided into three groups of similar measurement approaches, and compared to those obtained on rigid sigmoidoscopy. The anal verge location relative to the external anal sphincter was assessed on oblique coronal T2WI in reference to the markers. Correlation analysis was performed using the intraclass correlation coefficient (ICC) for verification, and a paired t test was used to evaluate the mean differences. Results The highest correlation (ICC 0.797–0.815) and the least mean difference (0.74–0.85 cm) with rigid sigmoidoscopy, and the least standard deviation (3.12–3.17 cm) were obtained in the direct methods group using a straight line from the anal verge to the tumor. The anal verge was localized within a range of − 1.4 to 1.5 cm (mean − 0.31 cm and − 0.22 cm) from the lower end of the external anal sphincter. Conclusion The direct methods group provided the most accurate tumor distance among the groups. Among the direct methods, we recommend the direct mass method for its simplicity. Despite minor differences in location, the lower end of the external anal sphincter was a reliable anatomical landmark for the anal verge.
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