Abstract
Magnetic resonance imaging is used to non-invasively stage and restage rectal adenocarcinomas. Accurate staging is important as the depth of tumor extension and the presence or absence of lymph node metastases determines if an individual will undergo preoperative neoadjuvant chemoradiation. Accurate description of tumor location is important for presurgical planning. The relationship of the tumor to the anal sphincter in addition to the depth of local invasion determines the surgical approach used for resection. High-resolution T2-weighted imaging is the primary sequence used for initial staging. The addition of diffusion-weighted imaging improves accuracy in the assessment of treatment response on restaging scans. Approximately 10%–30% of individuals will experience a complete pathologic response following chemoradiation with no residual viable tumor found in the resected specimen at histopathologic assessment. In some centers, individuals with no residual tumor visible on restaging MR who are thought to be at high operative risk are monitored with serial imaging and a “watch and wait” approach in lieu of resection. Normal rectal anatomy, MR technique utilized for staging and restaging scans, and TMN staging are reviewed. An overview of surgical techniques used for resection including newer, minimally invasive endoluminal techniques is included.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2613-2629 |
| Number of pages | 17 |
| Journal | Abdominal Imaging |
| Volume | 40 |
| Issue number | 7 |
| DOIs | |
| State | Published - Oct 29 2015 |
| Externally published | Yes |
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Keywords
- Magnetic resonance imaging
- Rectal adenocarcinoma
- Rectal cancer staging
ASJC Scopus subject areas
- Radiological and Ultrasound Technology
- Radiology Nuclear Medicine and imaging
- Gastroenterology
- Urology
Cite this
Magnetic resonance imaging of rectal cancer : staging and restaging evaluation. / Moreno, Courtney C.; Sullivan, Patrick S.; Kalb, Bobby T.; Tipton, Russell G.; Hanley, Krisztina Z.; Kitajima, Hiroumi D.; Dixon, W. Thomas; Votaw, John R.; Oshinski, John N.; Mittal, Pardeep Kumar.
In: Abdominal Imaging, Vol. 40, No. 7, 29.10.2015, p. 2613-2629.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Magnetic resonance imaging of rectal cancer
T2 - staging and restaging evaluation
AU - Moreno, Courtney C.
AU - Sullivan, Patrick S.
AU - Kalb, Bobby T.
AU - Tipton, Russell G.
AU - Hanley, Krisztina Z.
AU - Kitajima, Hiroumi D.
AU - Dixon, W. Thomas
AU - Votaw, John R.
AU - Oshinski, John N.
AU - Mittal, Pardeep Kumar
PY - 2015/10/29
Y1 - 2015/10/29
N2 - Magnetic resonance imaging is used to non-invasively stage and restage rectal adenocarcinomas. Accurate staging is important as the depth of tumor extension and the presence or absence of lymph node metastases determines if an individual will undergo preoperative neoadjuvant chemoradiation. Accurate description of tumor location is important for presurgical planning. The relationship of the tumor to the anal sphincter in addition to the depth of local invasion determines the surgical approach used for resection. High-resolution T2-weighted imaging is the primary sequence used for initial staging. The addition of diffusion-weighted imaging improves accuracy in the assessment of treatment response on restaging scans. Approximately 10%–30% of individuals will experience a complete pathologic response following chemoradiation with no residual viable tumor found in the resected specimen at histopathologic assessment. In some centers, individuals with no residual tumor visible on restaging MR who are thought to be at high operative risk are monitored with serial imaging and a “watch and wait” approach in lieu of resection. Normal rectal anatomy, MR technique utilized for staging and restaging scans, and TMN staging are reviewed. An overview of surgical techniques used for resection including newer, minimally invasive endoluminal techniques is included.
AB - Magnetic resonance imaging is used to non-invasively stage and restage rectal adenocarcinomas. Accurate staging is important as the depth of tumor extension and the presence or absence of lymph node metastases determines if an individual will undergo preoperative neoadjuvant chemoradiation. Accurate description of tumor location is important for presurgical planning. The relationship of the tumor to the anal sphincter in addition to the depth of local invasion determines the surgical approach used for resection. High-resolution T2-weighted imaging is the primary sequence used for initial staging. The addition of diffusion-weighted imaging improves accuracy in the assessment of treatment response on restaging scans. Approximately 10%–30% of individuals will experience a complete pathologic response following chemoradiation with no residual viable tumor found in the resected specimen at histopathologic assessment. In some centers, individuals with no residual tumor visible on restaging MR who are thought to be at high operative risk are monitored with serial imaging and a “watch and wait” approach in lieu of resection. Normal rectal anatomy, MR technique utilized for staging and restaging scans, and TMN staging are reviewed. An overview of surgical techniques used for resection including newer, minimally invasive endoluminal techniques is included.
KW - Magnetic resonance imaging
KW - Rectal adenocarcinoma
KW - Rectal cancer staging
UR - http://www.scopus.com/inward/record.url?scp=84942501562&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84942501562&partnerID=8YFLogxK
U2 - 10.1007/s00261-015-0394-z
DO - 10.1007/s00261-015-0394-z
M3 - Review article
C2 - 25759246
AN - SCOPUS:84942501562
VL - 40
SP - 2613
EP - 2629
JO - Abdominal Radiology
JF - Abdominal Radiology
SN - 2366-004X
IS - 7
ER -