Preoperative Staging of Rectal Cancer with MR Imaging: Correlation with Surgical and Histopathologic Findings

Iafrate, Franco; Laghi, Andréa; Paolantonio, Pasquale; Rengo, Marco; Mercantini, Paolo; Ferri, Mario; Ziparo, Vincenzo; Passariello, Roberto

doi:10.1148/rg.263055086

Cited by 116 publications

(55 citation statements)

References 50 publications

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“…Rectal cleansing has been performed to prevent image misinterpretation due to stool residues. However, distension of the rectal lumen is controversial (20). In a study by Brown et al (29), optimal results were obtained without rectal luminal distension.…”

Section: Discussionmentioning

confidence: 99%

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The ability of phased-array MRI in preoperative staging of primary rectal cancer: correlation with histopathological results

Karatağ

Karatağ²,

Özkurt³

et al. 2011

Diagn Interv Radiol

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20T he prognosis and treatment of rectal carcinoma depends on the tumor stage at presentation (1). Local tumor extent, involved lymph nodes, and the presence of distant metastases are the main factors that influence prognosis (1-5). A poor prognosis of rectal cancer is associated with a high risk of metastases and local recurrence (6). Incomplete removal of the tumor is the major cause of local recurrence, which varies from 3% to 32% (7,8). Total mesorectal excision (TME) is the standard surgical approach in primary rectal cancer. TME involves the removal of the mesorectum, which contains the rectal tumor, all local draining nodes and the mesorectal fat by sharp dissection along the mesorectal fascia (9-12). This minimizes the chance of any tumor being left behind and results in a substantial reduction of the high local recurrence rate to less than 10% (8, 13) even without adjunctive treatment (13,14). When performing TME, knowledge of the relationship of the tumor to the circumferential resection margin (CRM) is important. When the CRM is involved with the tumor, the risk of local recurrence is high (9,(15)(16)(17).Chemoradiation therapy is the standard adjunctive preoperative treatment for patients with a high likelihood of curative resection failure (14,18). According to the recent literature, patients who received preoperative chemoradiation therapy had a lower rate of local recurrence compared to patients who received postoperative chemotherapy and radiation therapy (1,19). Therefore, there is a need for preoperative imaging methods to aid in the identification of patients with extrarectal spread who may benefit from preoperative chemoradiation therapy (20).Magnetic resonance imaging (MRI) is the most promising diagnostic method for the preoperative local staging of rectal cancer (8,21). Spatial resolution has dramatically improved with advances in MRI techniques, such as the use of endorectal and phased-array coils (22,23). Current evidence suggests that MRI is the most accurate technique for predicting tumor stage (24) because it provides an assessment of the local prognostic factors, including the extent of extramural tumor spread, the involvement of the lateral resection margin, the involvement of neighboring organs in the pelvis, the presence of local lymph node metastases, extramural lymphovascular infiltration and peritoneal involvement (9,25,26).The purposes of this study were to evaluate the accuracy of MRI performed with phased-array coil for preoperative local tumor staging in patients with rectal cancer and emphasize the importance of the preoperative differentiation of T2 tumors from T3 so the appropriate treatment plan can be applied. Materials and methods PatientsTwenty-four patients with histopathologically proven primary rectal cancer were prospectively examined using MRI with a phased-array PURPOSEThis study evaluated the accuracy of phased-array magnetic resonance imaging (MRI) for preoperative local tumor staging in primary rectal cancer and emphasized the importance of the preoperativ...

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Section: Discussionmentioning

confidence: 99%

“…Therefore, the main purpose of the preoperative staging of rectal tumors with MRI is to identify patients with T3 lesions, a subset of whom have potential CRM involvement and may benefit from neoadjuvant treatment (e.g., radiation therapy and chemotherapy) (20).…”

Section: Discussionmentioning

confidence: 99%

The ability of phased-array MRI in preoperative staging of primary rectal cancer: correlation with histopathological results

Karatağ

Karatağ²,

Özkurt³

et al. 2011

Diagn Interv Radiol

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show abstract

“…80,81 However, ERUS is not reliable in assessing lymph node positivity. [82][83][84][85] Nonetheless, the combination of digital rectal examination, ERUS and flexible sigmoidoscopy with biopsy is the recommended preoperative staging and tumour assessment strategy when considering TEM. In otherwise appropriate candidates who have an ERUS suggestive of T2 or T3 disease but in whom there is clinical suspicion of early cancer, TEM can still be used to confirm T stage in patients who are reluctant to undergo radical resection; early salvage surgery can still be performed postoperatively if advanced rectal cancer is identified.…”

Section: Early Rectal Adenocarcinomasmentioning

confidence: 99%

Transanal endoscopic microsurgery: a review

Heidary

Phang

Raval

et al. 2014

cjs

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“…To order printed copies, contact reprints@rsna.org covered by peritoneum anteriorly and laterally, and the mid rectum is only partially covered anteriorly (8,9). The distal rectum is entirely extraperitoneal and is surrounded by perirectal fat, mesorectal lymph nodes, and vessels, all of which are encased by the mesorectal fascia (9,10). The mesorectal fascia tapers inferiorly and fuses with the anal sphincter (Fig 2) (8-11).…”

Section: Introductionmentioning

confidence: 99%

Anorectal Cancer: Critical Anatomic and Staging Distinctions That Affect Use of Radiation Therapy

Matalon¹,

Mamon²,

Fuchs³

et al. 2015

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Preoperative Staging of Rectal Cancer with MR Imaging: Correlation with Surgical and Histopathologic Findings

Cited by 116 publications

References 50 publications

The ability of phased-array MRI in preoperative staging of primary rectal cancer: correlation with histopathological results

The ability of phased-array MRI in preoperative staging of primary rectal cancer: correlation with histopathological results

Transanal endoscopic microsurgery: a review

Anorectal Cancer: Critical Anatomic and Staging Distinctions That Affect Use of Radiation Therapy

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