Assessment of a rectal SPECC lesion by endoluminal ultrasound

Abstract

One of the main themes of the SPECC (significant polyp and early colorectal cancer) programme has been the importance of detailed and thorough assessment and planning, principally before intervention. Endoluminal ultrasound (probably best referred to as endorectal or transrectal ultrasound, or TRUS, to distinguish the modality from endoanal scanning assessment of the canal and pelvic floor structures) has experienced a renaissance of interest in this context. From a heyday in the late 1990s and early 2000s, increasing use of magnetic resonance imaging (MRI) saw TRUS somewhat fall from favour in the UK, although it has remained in widespread use in continental Europe. Whilst TRUS has remained in continuous use in specialist units in the UK for the full range of rectal lesions, focus on the evaluation of complex lesions rather than simply proven rectal cancers has led to a reappraisal of its role. TRUS is advocated in concert with MRI for lesion assessment with the aim of specifically choosing optimum treatment for a rectal SPECC in the context of the wide range of therapeutic options now available.