Keywords:
Ethics, Diagnostic procedure, MR, Oncology, Gastrointestinal tract, Abdomen, Cancer
Authors:
M. A. van der Lubbe, L. Molenaar, J. J. M. van Griethuysen, M. J. Lahaye, M. Maas, G. L. Beets, R. G. H. Beets-Tan, D. M. J. Lambregts; Amsterdam/NL
DOI:
10.1594/ecr2018/C-1533
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 of small recurrent tumor in the rectal wall.
However,
gas in the rectal lumen can cause significant susceptibility artifacts on DWI,
which can make correct interpretation of DWI images very difficult (see Fig. 1 ).
A recent study showed that a small (5 ml) preparatory micro-enema can significantly reduce the gas in the rectal lumen to avoid susceptibility artifacts and thereby greatly improve the quality of rectal DWI (2).
Patients are typically asked to self-administer such a micro-enema shortly before the MRI.
Although this is a fairly simple procedure,
little is known about how patients experience the procedure and whether or not it poses a great burden.
The aim of this study was to objectify patients’ experience using questionnaires and to explore whether there are any practical issues that can be taken into account to further improve patient comfort.