Quality of preoperative pelvic computed tomography (CT) and magnetic resonance imaging (MRI) for rectal cancer in a region in Ontario: A retrospective population‐based study
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abstract
Background and ObjectivesTreatment decisions for rectal cancer rely on preoperative staging with CT and MRI scans. We assessed the quality of such scans in a region of Ontario.MethodsWe retrospectively collected data for patients undergoing rectal cancer surgery between July 2011 and December 2014. We measured three aspects of quality: use; comprehensiveness of reporting T‐category, N‐category, mesorectal fascia (MRF) status; and in non‐radiated patients sensitivity and specificity of reports for relevant elements.ResultsA total of 559 patients underwent major rectal cancer surgery. Preoperative staging with CT and MRI was performed in 93% and 50% of patients. CT scan reports provided information on T‐category, N‐category, and MRF status in 41%, 92%, and 16% of cases. These same elements were reported on MRI in 88%, 93%, and 62% of cases. CT scan sensitivity and specificity was 80% and 80% for T‐category, and 85% and 39% for N‐category. MRI sensitivity and specificity was 75% and 81% for T‐category, 79% and 37% for N‐category, and 33% and 89% for MRF status.ConclusionIn this region of Ontario, pre‐operative MRI was underutilized, CT reporting of MRF status was low, and when reported sensitivity and specificity of T‐ and N‐category were similar for CT and MRI.
