Preoperative Staging

The last decade has seen a big change in the treatment of rectal cancers. Treatment is now based on clinical staging. The perfect staging modality should be easily available, operator independent, and cost effective and have a high accuracy and sensitivity. The techniques currently available are the endorectal ultrasound (ELUS), computerized tomography (CT) scanning, MR scanning, 3D ultrasound (3D US), and PET scanning. The popular imaging techniques are ELUS for local disease and CT for metastasis. ELUS is operator dependent and has a high accuracy for the T stage, while CT is an excellent tool for distant disease. MR using endocoil is popular in the United Kingdom with a high accuracy. 3D US is also gaining popularity, and PET scanning is a useful technique for recurrent and metastatic disease.