Learning objectives
In this paper we review the current role of MRI in the diagnosing and management of rectal cancer in order to provide a structured and complete radiological report. At the end of it, the reader should be able to:
1.Recognize the important anatomic landmarks for local staging
2.Choose the proper MRI protocol
3.Describe the morphologic characteristics of the tumor relevant in staging
4.Identify nodal involvement and extramural vascular invasion
Background
Over the past few decades, survival rates in rectal cancer have increased significantly and one key role was played by the improvement of MRI which led to a more accurate TNM staging and thus to a better treatment selection. The standard treatment for locally stable disease is total mesorectum excision (TME) and neoadjuvant therapy followed by TME for locally advanced disease. Currently, MRI is the gold standard in differentiating stable from advanced local disease.[1]
Findings and procedure details
Acquisition and technique
The potential benefits of MRI in the patient management are strictly dependent on obtaining high quality images that allow characterization of the main anatomic structures and their relationship. The most important sequence in the imaging of rectal cancer is T2-weighted high-resolution (section thickness under 3 mm) because of its high contrast and good resolution on soft tissues. The strength of the magnetic field is also paramount in obtaining high quality images, thus it’s recommended to use 1.5 or 3T MRI machines.[1]
Usually,...
Conclusion
MRIhas a great impact on patients’ management so it becomes important to write a structured and complete report, which provides useful information to the multidisciplinary team.
Personal information and conflict of interest
C.-I. Betianu; Bucharest/RO - nothing to disclose A. Bajenaru; Bucharest/RO - nothing to disclose
References
1. MRI of Rectal Cancer: Tumor Staging, Imaging Techniques, and Management. Natally Horvat, MD Camila Carlos Tavares Rocha, MD Brunna Clemente Oliveira, MD Iva Petkovska, MD Marc J. Gollub, MD. 2019, RadioGraphics, pp. 367-387.
2. Diffusion-weighted imaging in rectal cancer: current applications and future perspectives. Schurink, NW, Lambregts, DMJ and Beets-Tan, RGH. 2019, The British Journal of Radiology.
3. MRI in local staging of rectal cancer: an update. Ümit, Tapan, Mustafa, Özbayrak and Servet, Tatlı. 2014, Diagnostic and Interventional radiology, pp. 390-398.
4. MRI of...