Validity of Linear Endoscopic Ultrasound in Rectal lesions Evaluation

Bazeed, Shamardan Ezzeldin Sayed; Saed, Mohamed Tag-Eldin; Abdelaziz, Ahmed Alyan; Ghweil, Ali Abdelrahman Sayed

doi:10.21608/svuijm.2024.253983.1754

Validity of Linear Endoscopic Ultrasound in Rectal lesions Evaluation

Document Type : Original research articles

Authors

¹ Tropical Medicine and Gastroenterology Department, Faculty of Medicine South Valley University, Qena, Egypt.

² Internal Medicine and Gastroenterology Department, Faculty of Medicine South Valley University, Qena, Egypt.

10.21608/svuijm.2024.253983.1754

Abstract

Background: Rectal examinations utilize radial and linear EUS probes for specific areas. Linear probes offer deep visualization but pose challenges in pelvic anatomy. Rectal lesion evaluations use CT, MRI, and EUS, with EUS and MRI are often complementary. Linear EUS is gaining popularity for GI tract lesions' assessment.
Objectives: To assess the accuracy of linear –array Endoscopic Ultrasound in rectal lesions evaluation.
Patients and methods: Cross-sectional study in 40 Egyptian patients with rectal lesion. Linear EUS (Fuji EG-580UT) was compared to CT/MRI. Colonic prep, clinical assessments, sedation, FNA procedures were conducted. EUS examined lesions, layers, lymph nodes, and extend were evaluated. Samples were processed by cytopathologists. Outcomes were assessed including EUS diagnoses, CT/MRI/EUS comparisons and impact on patient management.
Results: The research comprised 40 rectal lesions patients. Patient age, gender, BMI, symptoms, and history were documented. CT, MRI, and EUS had 70%, 68%, and 65% malignancy diagnosis accuracy, respectively. EUS had the best sensitivity, specificity, PPV, NPV, and accuracy. EUS matched pathological T and N staging. Perfect AUCs demonstrated EUS advantage in T and N staging in ROC analysis.
Conclusion: CT had the highest diagnosis rate for rectal lesion malignancy, followed by MRI and then EUS. EUS was associated with the highest diagnostic, T staging, and N staging accuracy. CT had the highest diagnostic accuracy for early T and N stages, followed by MRI, while EUS had higher diagnostic accuracy for late T and N stages, suggesting that EUS could be the most reliable tool for preoperative diagnosis of rectal lesion staging.

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