Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPPINTO, Rodrigo AmbarKAWAGUTI, Fabio ShiguehissaKIMURA, Cintia Mayumi SakuraiCORREA NETO, Isaac Jose FelippeNAHAS, Caio Sergio RizkallahMARQUES, Carlos Frederico SparapanBUSTAMANTE-LOPEZ, Leonardo AlfonsoRIBEIRO-JR, UlyssesMALUF-FILHO, FauzeNAHAS, Sergio Carlos2024-04-052024-04-052024JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, v.39, n.2, p.346-352, 20240815-9319https://observatorio.fm.usp.br/handle/OPI/58884IntroductionAccurate assessment of invasion depth of early rectal neoplasms is essential for optimal therapy. We aimed to compare three-dimensional endorectal ultrasound (3D-ERUS) with magnification chromoendoscopy (MCE) regarding their accuracy in assessing parietal invasion depth (T).MethodsPatients with middle and distal rectum neoplasms were prospectively included. Two providers blinded to each other's assessment performed 3D-ERUS and MCE, respectively. The T stage assessed through ERUS was compared to the MCE evaluation. The results were compared to the surgical specimen anatomopathological report. Sensitivity, specificity, accuracy, positive (PPV), and negative (NPV) predictive values were calculated for the T stage and for the final therapy (local excision or radical surgery).ResultsIn 8 years, 70 patients were enrolled, and all underwent both exams. MCE and ERUS showed an accuracy of 94.3% and 85.7%, sensitivity of 83.7 and 93.3%, specificity of 96.4 and 83.6%, PPV of 86.7 and 60.9%, and NPV of 96.4 and 97.9%, respectively. Kappa for T stage assessed through ERUS was 0.64 and 0.83 for MCE.ConclusionMCE and 3D-ERUS had good diagnostic performance, but the endoscopic method had higher accuracy. Both methods reliably assessed lesion extension, circumferential involvement, and distance from the anal verge.engrestrictedAccessEarly rectal cancerEndorectal ultrasoundLocal stagingMagnification chromoendoscopycancerultrasonographysocietychemoradiationguidelinesmanagementefficacytumorscolonarticleCopyright WILEY10.1111/jgh.16382Gastroenterology & Hepatology1440-1746