The Use of MR Imaging in Treatment Planning for Patients with Rectal Carcinoma: Have You Checked the “DISTANCE”?

Nougaret, Stéphanie; Reinhold, Caroline; Mikhael, Hisham W; Rouanet, Philippe; Bibeau, Frédéric; Brown, Gina

doi:10.1148/radiol.13121361

Cited by 221 publications

(186 citation statements)

References 68 publications

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“…The initial MRI examination must allow defining the tumour position in relation to the sphincterian complex in order to identify patients who need preoperative RCT (49). Early-stage tumours traced through MRI, primary surgical treatment and avoiding sphincter irradiation lead to a better postoperative sphincterian function and to lower rates of anastomotic insufficiency (50).…”

Section: T Staging Specific To Low Rectal Tumours: Anal Complexmentioning

confidence: 99%

“…Exact nodal staging is important because the number of metastatic nodes has been shown to affect the prognosis (Table 1) (49). The involvement of nodes in the proximity of mesorectal fascia is associated with a higher local recurrence risk.…”

Section: Detection Localization Characterizationmentioning

confidence: 99%

“…By using these supplementary morphological criteria, the diagnostic safety in evaluating lymphoganglionary infiltration increases considerably (60,61,62). Using these criteria, MRI can be used for evaluating nodal involvement with an accuracy of 85%, comparing to histological evaluation which is the reference standard (49). However, a negative MRI result cannot completely exclude lymphatic metastases, because imaging techniques cannot trace micrometastasis inside lymph nodes.…”

Section: B the Lymph Nodes Morphologymentioning

confidence: 99%

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The Importance of Preoperative Staging of Rectal Cancer Using ultiparametric MRI Part II: TNM Cancer Staging

Bauer¹

2016

chr

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Section: T Staging Specific To Low Rectal Tumours: Anal Complexmentioning

confidence: 99%

Section: Detection Localization Characterizationmentioning

confidence: 99%

Section: B the Lymph Nodes Morphologymentioning

confidence: 99%

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The Importance of Preoperative Staging of Rectal Cancer Using ultiparametric MRI Part II: TNM Cancer Staging

Bauer¹

2016

chr

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“…To date, MRI at 3 T or the use of endorectal coils could not yield a significant diagnostic advantage [77,78]. The minimum diagnostic requirements are sagittal and paraaxial, thin-slice (voxel size at least 3 × 1 × 1 mm 3 ) T2-weighted sequences and diffusion-weighted and contrastenhanced T1-weighted sequences [78,79]. In the case of low-lying rectal cancer, coronal T2 and contrast-enhanced T1-weighted sequences must be additionally performed for the evaluation of a possible infiltration of the sphincter complex/extralevator and intersphincter fascia [79].…”

Section: Local Staging Of Rectal Cancermentioning

confidence: 99%

A Review of Scientific Topics and Literature in Abdominal Radiology in Germany – Part 1: Gastrointestinal Tract

Schreyer

Weßling

Kinner

et al. 2015

Fortschr Röntgenstr

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The working group for abdominal and gastrointestinal diagnosis is a group of the German Radiological Society (DRG) focusing clinically and scientifically on the diagnosis and treatment of the gastrointestinal tract with all parenchymatous abdominal organs. In addition to the clinical and scientific further development of abdominal radiology, the education of radiologists within this core discipline of radiology is one of the major aims. In this article we give an up-to-date literature review of scientific radiological topics especially covered by German radiologists. This manuscript focuses on the most recent literature on the diagnosis of the stomach, small bowel, colon and rectum. The review with a focus on the most recent studies published by German radiologists concludes with a synopsis of mesenterial bleeding and ischemia followed by a critical appraisal of the current literature on conventional abdominal radiography. Key Points: ??Based on recent literature and guidelines there is a change of paradigms regarding the diagnosis of esophagus and gastric cancer towards CT, which is considered equally to endosonography. ??For small bowel imaging in Crohn?s disease ultrasound as well as MRI with a new focus on DWI are the most important imaging modalities scientifically. ??For colonic diagnosis virtual colonoscopy has replaced the conventional radiological methods. For staging of rectal carcinoma as well as for therapeutic stratification a high resolution MRI of the pelvis is of paramount interest. ??Multislice CT is considered the most important modality to assess mesenteric ischemia or bleeding. Citation Format: ??Schreyer AG, Wessling J, Kinner S et?al. A Review of Scientific Topics and Literature in Abdominal Radiology in Germany ? Part 1: Gastrointestinal Tract. Fortschr R?ntgenstr 2016; 188: 134???145

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“…9,10 Given the complexity and number of parameters that need to be addressed when interpreting rectal MRI, synoptic reporting utilizing standardized templates is crucial to consistently report all facets of a tumor that have implications on management. 11,12 MRI has taken on an ever increasing role in the staging of rectal cancer since the MERCURY trial established strong concordance between radiologic and pathologic analysis of …”

mentioning

confidence: 99%

MRI Local Staging and Restaging in Rectal Cancer

dePrisco

2015

Clinics in Colon and Rectal Surgery

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The multidisciplinary team approach to rectal cancer has been validated to improve the outcome of patients with rectal cancer. 1,2 The radiologist's contribution in this arena is accurate staging and restaging local extent of disease. These are vital to improving patient survival with rectal cancer while at the same time lowering the morbidity and mortality which may be associated with local recurrence and metastatic disease. Accurate staging prevents undertreatment or overtreatment of rectal cancer. Current evidence-based guidelines support the use of either transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI) assessment of local disease extent. Despite these guidelines, recent research confirms appropriate local staging remains underutilized, particularly in the hands of general surgeons. 3 MRI has supplanted TRUS for staging in many institutions. MRI with rectal cancer protocol modification is now the preferred modality for rectal cancer staging and restaging in most specialty institutions. The aim of this article is (1) to highlight the utility of MRI for these purposes, emphasizing synoptic reporting, and (2) to examine barriers and solutions to appropriate MRI utilization in rectal cancer care. Magnetic Resonance Imaging StagingCurrent TNM staging in rectal cancer derives stage groupings based on (1) the depth of tumor invasion into the rectal wall and surrounding structures, including the peritoneum and surrounding viscera; (2) the presence and number of involved lymph nodes; and (3) the presence of metastatic disease to distant organs, distant lymph nodes, or distant portions of the peritoneum. The superior soft tissue contrast achieved with state-of-the-art rectal protocol MRI allows for measurement of the tumor depth of invasion (DOI) (T stage), determination of the relationship of the most invasive component of the tumor to the mesorectal fascia, and elucidation of the tumor's relationship to the sphincter complex, peritoneal reflection, and perirectal venous plexus (►Fig. 1A, B). 4 Furthermore, MRI is able to assess for lymph nodes and tumor deposits in the tissues beyond the mesorectal fascia, including the pelvic sidewall, which, if unaddressed, are a source of residual and/ or recurrent disease (►Fig. 2). 5-7 Though not currently included in current staging guidelines, the presence of extensive extramural vascular invasion as determined by MRI places patients at high risk for metastatic disease and is associated with poor survival. 8 The inception of minimally invasive treatment strategies, such as local transanal excision, underscores the need to accurately assess a tumor's relationship to the peritoneal reflection and the layers of the rectal wall muscle. Two large studies have recently confirmed the ability of MRI to determine the location of the tumor with respect to the anterior peritoneal reflection. MRI is able to identify the peritoneal reflection between 75 and 90% of cases. 9,10 Given the complexity and number of parameters that need to be addressed when interpreting rectal ...

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The Use of MR Imaging in Treatment Planning for Patients with Rectal Carcinoma: Have You Checked the “DISTANCE”?

Cited by 221 publications

References 68 publications

The Importance of Preoperative Staging of Rectal Cancer Using ultiparametric MRI Part II: TNM Cancer Staging

The Importance of Preoperative Staging of Rectal Cancer Using ultiparametric MRI Part II: TNM Cancer Staging

A Review of Scientific Topics and Literature in Abdominal Radiology in Germany – Part 1: Gastrointestinal Tract

MRI Local Staging and Restaging in Rectal Cancer

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