Diagnostic management of rectal cancer: current multimodality imaging approach

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2015

Poster Number:

C-1127

Type:

Educational Exhibit

Keywords:

Gastrointestinal tract, Pelvis, Oncology, MR, MR-Diffusion/Perfusion, Ultrasound, Imaging sequences, Diagnostic procedure, Neoplasia, Cancer, Multidisciplinary cancer care

Authors:

M. Arzanauskaite¹, M. Gutiérrez Gimeno², I. Gineikiene¹; ¹Kaunas/LT, ²Barcelona/ES

DOI:

10.1594/ecr2015/C-1127

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-1127

Fig. 3: Figure 3. T stages in rectal cancer. From left to right (counterclockwise): Tis...

Fig. 8: Figure 8. Red arrows show a T2 tumour that extends to the muscularis propia...

Fig. 12: Figure 12. Case 2. Stage T3 before treatment (first line, images 1A-1C) and a...

Fig. 13: Figure 13. Case 3. Stage T4 rectal cancer with a partial response to treatment....

Learning objectives

To provide a schematic, illustrative overview about diagnostic management of rectal cancer To summarize the most important epidemiological features of rectal cancer, explaining the utterly importance of an accurate diagnostic approach. To explain the utterly importance of an accurate staiging of the disease and develop the role of EUS, CT, MRI and PET in the diagnostic management of the disease.

Background

Before discussing rectal pathology and its imaging, it is vital to be acquainted with the regional anatomy. The rectum is the lowest part of the gastrointestinal tract. Its histological structure similar to that of the colon with one important difference: whereas the colon is surrounded by an outer layer of connective tissue called the serosa, meanwhile the rectum, mostly is surrounded by fatty tissue, the mesorectum. The mesorectum contains lymph nodes, vessels, and several fibrous septa. A thin layer of connective tissue, the mesorectal fascia,...

Findings and procedure details

Endorectal ultrasound (EUS) imaging Technique EUS is an good technique for visualizing in vivo a suspicious lesion, to take biopsies, and to assess he rectal wall and mesorectal tissue. Flexible probe allows to evaluate up to 30 cm from anal sphincter, and to assess iliac lymph nodes. If a rigid probe is used, only 8-10 cm can be evaluated. The most widely used EUS endoscopes are oblique forward viewing echo-endoscopes. They allow a 360° image on a plane perpendicular to the long axis of the...

Conclusion

Rectal cancer, being a common neoplastic disease with important morbidity and mortality rates, requires a thorough diagnostic evaluation. Knowledge of different appearance findings on multimodality imaging aids for a correct diagnosis and accurate staging.

Personal information

References

1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90. 2. Glimelius B, Påhlman L, Cervantes A. Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010 May 1;21(suppl 5):v82–6. 3. Kang H, O’Connell JB, Leonardi MJ, Maggard MA, McGory ML, Ko CY. Rare tumors of the colon and rectum: a national review. Int J Colorectal Dis. 2007 Feb;22(2):183–9. 4. Compton CC. Colorectal carcinoma: diagnostic, prognostic, and molecular features. Mod...