The impact of mismatch repair status and systemic inflammatory markers on radiological staging in colon cancer.

Objective: Mismatch repair (MMR) deficient (dMMR) colon cancer (CC) is distinct from MMR proficient (pMMR) CC, yet the impact of MMR status on radiological staging is unclear. The purpose of this study was to investigate how MMR status impacts CC CT staging.

Methods: We retrospectively compared CT staging accuracy between dMMR and pMMR CC patients undergoing curative resection.

Current controversies in TNM for the radiological staging of rectal cancer and how to deal with them: results of a global online survey and multidisciplinary expert consensus.

Objectives: To identify the main problem areas in the applicability of the current TNM staging system (8 ed.) for the radiological staging and reporting of rectal cancer and provide practice recommendations on how to handle them.

Methods: A global case-based online survey was conducted including 41 image-based rectal cancer cases focusing on various items included in the TNM system.

British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines.

These consensus guidelines were jointly commissioned by the British Society of Gastroenterology (BSG), the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and Public Health England (PHE). They provide an evidence-based framework for the use of surveillance colonoscopy and non-colonoscopic colorectal imaging in people aged 18 years and over. They are the first guidelines that take into account the introduction of national bowel cancer screening.

Magnetic Resonance Imaging for Perianal Fistula.

Perianal fistulas and other inflammatory diseases of the anus and perianal soft tissues are a cause of substantial morbidity, and are a major part of the practice of any colorectal surgeon. Magnetic resonance imaging (MRI) has a key role in the assessment of patients for the extent of fistulizing Crohn disease, complications related to fistulas, and to assist in confirming the diagnosis or proposing an alternative. Technique is critical and in particular, the selection of sequences for diagnosis and characterization of abnormalities with the main choices being between standard anatomical sequences (T1 or T2), assessing for edema (FS T2 or STIR), assessing abnormal contrast enhancement (FS T1), and assessing for abnormal diffusion or a combination of these.

CT assessment of right colonic arterial anatomy pre and post cancer resection - a potential marker for quality and extent of surgery?

Background: There is conflicting opinion as to the optimum extent of resection for right-sided colonic cancer, which is currently graded by pathological analysis of the resected specimen. It is not known if computed tomography (CT) analysis of residual post-resection arterial stump length could be used as an alternative in vivo marker for extent of mesenteric resection. Ileocolic artery stumps have been demonstrated previously on CT after right hemicolectomy, but only in the early postoperative period.

Colonoscopy for colonic wall thickening at computed tomography: a worthwhile pursuit?

Background: In the absence of official guidance for the management of colonic wall thickening identified by computed tomography (CT), a common clinical dilemma surrounds the volume of colonoscopies subsequently performed.

Methods: To identify whether colonic wall thickening identified at CT consistently warrants colonoscopy, consecutive colonoscopies performed at Leeds Teaching Hospitals Trust in 2008 and recorded as "possible colonic lesion on cross-sectional abdominal CT" in an endoscopic database were retrospectively analyzed. Clinical, radiologic, colonoscopic, and histologic data were obtained from medical records.

MR enterographic manifestations of small bowel Crohn disease.

Magnetic resonance (MR) enterography is a clinically useful technique for the evaluation of both intraluminal and extraluminal small bowel disease, particularly in younger patients with Crohn disease. MR enterography offers the advantages of multiplanar capability and lack of ionizing radiation. It allows evaluation of bowel wall contrast enhancement, wall thickening, and edema, findings useful for the assessment of Crohn disease activity.

Replacing barium enema with CT colonography in patients older than 70 years: the importance of detecting extracolonic abnormalities.

Objective: The objective of our study was to evaluate the significance of extracolonic abnormalities in patients older than 70 years referred for CT colonography (CTC).

Materials And Methods: We performed a retrospective analysis of 400 consecutive patients older than 70 years undergoing CTC over a 14-month period. All patients presented with weight loss, alteration of bowel habits, rectal blood loss, abdominal pain, or anemia; these symptoms led to clinical suspicion of lower gastrointestinal abnormalities.