Tumor Height Measurement in Rectal Cancer: A Comparative Study of Rigid Rectoscopy and Pelvic MRI
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ID: 315772
2026
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Abstract
Abstract Background Tumor height is a critical factor in the management of rectal cancers; yet there is no standardized reporting method. Pelvic magnetic resonance imaging (MRI) and rigid rectoscopy are the primary tools for measuring tumor height. Aims To compare the accuracy of rigid rectoscopy and MRI in measuring tumor height in patients with rectal cancer. Methods We conducted a retrospective review of patients who underwent both preoperative rigid rectoscopy and pelvic MRI for rectal cancer located within 12 cm of the anal verge (AV) between 2007 and 2018. An expert radiologist evaluated the MRI by measuring the distance from the AV using two lines: one from the AV to the upper end of the anal canal and another from the upper end to the lower border of the tumor. The primary outcome was the agreement between tumor heights measured by rigid rectoscopy and pelvic MRI. Results Ninety-eight patients underwent both procedures. The mean tumor height measured by rigid rectoscopy was 6.3 cm (SD 3.1), and by MRI was 6.9 cm (SD 3.2). A Bland Altmann plot (Figure 1) indicated good agreement between measurements with a mean difference of 0.6 cm. Regression analysis revealed a significant correlation between the two methods (p < 0.001). Notably, measurements differed by more than 2cm in 11 patients (11.2%), with a maximal discrepancy of 5.8cm. Upon reviewing the peri-operative and histopathological data for these cases, MRI was found to be more accurate in half of the patients, while rigid rectoscopy was determined to be more accurate in the other half. Conclusion There is a strong correlation between tumor height measurements from rigid rectoscopy and MRI. However, notable discrepancies highlight the need for standardized reporting. Since tumor height significantly influences treatment strategies, employing a combination of both techniques may enhance evaluation.For image description, please refer to the figure legend and surrounding text.
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| Authors | C de Vico, M Burgard, F Pugin, L W Widmer, F Cherbanyk |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag055.049
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| URL | |
| Keywords | Keywords not found |
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