Aims and objectives
At our institution,
patients with a rectum carcinoma who have undergone a complete response after chemoradiotherapy may be treated with a wait-and-see approach instead of surgical resection.
With a wait-and-see approach no surgery will be performed as long as there’s no evidence of recurrent tumor in the rectum.
Follow-up of patients is typically done with an MRI of the rectum,
sigmoidoscopy,
physical examination and blood tests (1).Nowadays,
diffusion-weighted imaging (DWI) is an integral part of the rectal MRI protocol as it can improve the detection...
Methods and materials
Patient population: 29 patients (10 female/ 19 male) with an age ranging between 47 and 84 years were included in this study.
All patients were clinical complete responders after chemoradiotherapy who underwent rectal MRI as part of a wait-and-see follow-up program.
Data acquisition and analyses:Patients scheduled to undergo rectal MRI+DWI were asked to self-administer a preparatory micro-enema (5 ml; natriumlaurylsulfoacetaat sorbitol) ±30 minutes before the MRI acquisition.
After completion of the MRI,
patients were subjected to a questionnaire in which they were asked whether they...
Results
The outcome of the questionnaire is displayed in Fig. 2 .
None of the 29 patients reported the self-administration as highly uncomfortable.
Eighteen patients (62%) reported no discomfort and eleven patients (38%) experienced mild discomfort.
Main reasons for mild discomfort (displayed in Fig. 3 ) were:
Unsatisfactory toilet facilities (17%),
e.g.; small toilet,
lack of privacy,
long distance from toilet to MRI
Fear of leakage of the enema fluid during the MR-acquisition (7%)
Fear that self-administration would be unsuccessful (14%)
None of the patients actually...
Conclusion
The patient burden for self-administration of a rectal micro-enema shortly prior to MRI is low: none of patients interviewed in this study reported any severe discomfort.
Approximately one third of the patients experienced some mild discomfort,
mainly related to unsatisfactory toilet facilities,
fear of leakage during the MR-acquisition and fear that self-administration might be unsuccessful.
None of the patients actually experienced any leakage during MR-acquisition.
Ensuring easy access to spacious toilet facilities and reassuring patients that self-administration is a simple procedure that will typically not...
Personal information
M.
van der Lubbe,
radiographer,
Department of Radiology,
Netherlands Cancer Institute.
P.O.
Box 90203,
1006 BE Amsterdam,
the Netherlands Phone: +31205129111 email:
[email protected]
L.
Molenaar,
radiographer,
Department of Radiology,
Netherlands Cancer Institute.
P.O.
Box 90203,
1006 BE Amsterdam,
the Netherlands Phone: +31205129111 email:
[email protected]
J.
van Griethuysen,
PhD student,
Department of Radiology,
Netherlands Cancer Institute.
P.O.
Box 90203,
1006 BE Amsterdam,
the Netherlands Phone: +31205129111
Dr.
M.
Maas,
radiologist,
Department of Radiology,
Netherlands Cancer Institute.
P.O.
Box 90203,
1006 BE Amsterdam,
the Netherlands Phone: +31205129111...
References
Martens MH,
Maas M,
Heijnen LA,
Lambregts DM,
Leijtens JW,
Stassen LP,
et al.
Long-term Outcome of an Organ Preservation Program After Neoadjuvant Treatment for Rectal Cancer.
J Natl Cancer Inst.
2016;108(12).
van Griethuysen J,
Bus E,
Hauptmann M,
Lahaye M,
Maas M,
ter Beek L,
et al.
Gas-induced susceptibility artefacts on diffusion-weighted MRI of the rectum at 1.5T - effect of applying a micro-enema to improve image quality.
Eur J Radiol.
2018;99:131-7.