Sensibilidad y especificidad entre la resonancia magnética nuclear y la tomografía axial computarizada en la evaluación de la extensión del cáncer de recto
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2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Introducción: la estadificación de un cáncer de recto es un proceso importante para determinar cuáles serán las indicaciones terapéuticas, sobre todo de gran importancia para el cirujano para determinar la extensión de la cirugía o para determinar la necesidad de un tratamiento neoadyuvante. Son varias las pruebas disponibles, sin embargo, la resonancia magnética nuclear y la tomografía axial computarizada son las más empleadas para la estadificación del tumor, emplean los criterios TNM para evaluar el tamaño del tumor, la invasión ganglionar y la existencia de metástasis.
Objetivo: el objetivo de esta investigación es determinar la precisión de la tomografía computarizada vs la resonancia magnética nuclear en la evaluación de la extensión del cáncer de recto en pacientes del servicio de gastroenterología del Hospital de Especialidades Teodoro Maldonado Carbo, Guayaquil 2019-2021
Materiales y métodos: se realizará un estudio observacional descriptivo de corte transversal para validación con una muestra de 108 pacientes por cada método diagnóstico a pacientes con cáncer de recto atendidos en el servicio de gastroenterología del Hospital de Especialidades Teodoro Maldonado Carbo de la ciudad de Guayaquil-Ecuador, desde el 1 de enero del 2019 hasta el 31 de diciembre del 2021. El análisis se realizó análisis de la sensibilidad, especificidad, valores predictivos y las curvas ROC.
Resultados: la Tomografía Axial Computarizada (TAC), 95 fueron verdaderos positivos con 89,6% y 11 falsos negativos con una tasa del 10,4%; mientras que la Resonancia Magnética Nuclear (RMN) no existió ningún falso negativo, es decir una tasa de sensibilidad del 100%. Respecto a los diagnósticos negativos, se identificaron 96 Verdaderos Negativos con una tasa del 90,6% y 10 Falsos Positivos que representa una tasa de 9,4%, mientras que a través de la RMN no existieron Falsos Positivos, por lo tanto una tasa de especificidad del 100%..
Introduction: staging of rectal cancer is an important process to determine what the therapeutic indications will be, especially of great importance for the surgeon to determine the extent of surgery or to determine the need for neoadjuvant treatment. There are several tests available, however, nuclear magnetic resonance and computerized axial tomography are the most used for tumor staging, they use TNM criteria to assess tumor size, lymph node invasion, and the existence of metastasis. Objective: the objective of this research is to determine the accuracy of computed tomography vs nuclear magnetic resonance in the evaluation of the extension of rectal cancer in patients of the gastroenterology service of the Hospital de Especialidades Teodoro Maldonado Carbo, Guayaquil 2019-2021 Materials and methods: a cross-sectional descriptive observational study will be carried out for validation with a sample of 108 patients for each diagnostic method in patients with rectal cancer treated in the gastroenterology service of the Hospital de Especialidades Teodoro Maldonado Carbo in the city of Guayaquil. Ecuador, from January 1, 2019 to December 31, 2021. The analysis was carried out on sensitivity, specificity, predictive values and ROC curves. Results: the Computed Axial Tomography (CT), 95 were true positives with 89.6% and 11 false negatives with a rate of 10.4%; while the Nuclear Magnetic Resonance (NMR) did not exist any false negative, that is to say, a sensitivity rate of 100%. Regarding the negative diagnoses, 96 True Negatives were identified with a rate of 90.6% and 10 False Positives, which represents a rate of 9.4%, while through MRI there were no False Positives, therefore a rate 100% specificity. Keywords: rectal cancer, tumor staging, diagnostic test validation, magnetic resonance imaging, computed tomography.
Introduction: staging of rectal cancer is an important process to determine what the therapeutic indications will be, especially of great importance for the surgeon to determine the extent of surgery or to determine the need for neoadjuvant treatment. There are several tests available, however, nuclear magnetic resonance and computerized axial tomography are the most used for tumor staging, they use TNM criteria to assess tumor size, lymph node invasion, and the existence of metastasis. Objective: the objective of this research is to determine the accuracy of computed tomography vs nuclear magnetic resonance in the evaluation of the extension of rectal cancer in patients of the gastroenterology service of the Hospital de Especialidades Teodoro Maldonado Carbo, Guayaquil 2019-2021 Materials and methods: a cross-sectional descriptive observational study will be carried out for validation with a sample of 108 patients for each diagnostic method in patients with rectal cancer treated in the gastroenterology service of the Hospital de Especialidades Teodoro Maldonado Carbo in the city of Guayaquil. Ecuador, from January 1, 2019 to December 31, 2021. The analysis was carried out on sensitivity, specificity, predictive values and ROC curves. Results: the Computed Axial Tomography (CT), 95 were true positives with 89.6% and 11 false negatives with a rate of 10.4%; while the Nuclear Magnetic Resonance (NMR) did not exist any false negative, that is to say, a sensitivity rate of 100%. Regarding the negative diagnoses, 96 True Negatives were identified with a rate of 90.6% and 10 False Positives, which represents a rate of 9.4%, while through MRI there were no False Positives, therefore a rate 100% specificity. Keywords: rectal cancer, tumor staging, diagnostic test validation, magnetic resonance imaging, computed tomography.
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Neoplasias del recto, Tomografía computarizada por rayos X, Resonancia magnética, Hospital de Especialidades Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador