Colorectal carcinoma, preoperative evaluation by spiral computed tomography.

OBJECTIVES To assess the capability of spiral computed tomography (CT) scan in preoperative evaluation of colorectal carcinoma (CRC). METHODS A cross sectional study on 52 patients with recent histopathologic diagnosis of CRC was conducted over a period of one year at the Aga Khan University Hospital, Karachi. All these patients underwent spiral CT with oral and intravenous contrast administration. Surgery was subsequently done in all cases and surgical specimens were sent for detailed pathologic analysis. The radiologic findings on the CT scans were compared with the pathological findings. RESULTS The results proved that spiral CT had 60% sensitivity and 83% specificity for assessment of local spread of disease, 66% sensitivity and 76% specificity for the evaluation of lymph nodal metastases and 89% sensitivity and 94% specificity for hepatic metastases. In all the cases, the visualized tumour growth with wide zone of resection and regional nodal chains were surgically removed. It was however, the distant metastases which made a difference to the type of curative or palliative surgery planned and in this study spiral CT had 92% accuracy for detection of hepatic metastases. CONCLUSION With technological advances and improvement in imaging protocols the results for local tumor spread are expected to improve, however based on the accuracy in detecting hepatic metastases in clinically unsuspected patients, this study proves that spiral CT has a significant role in preoperative evaluation and subsequent management of CRC.