Abdominal Radiology

, Volume 44, Issue 1, pp 1–10 | Cite as

Extramural venous invasion in rectal cancer: overview of imaging, histopathology, and clinical implications

  • Hamideh Ale Ali
  • Richard Kirsch
  • Suzan Razaz
  • Aaditeya Jhaveri
  • Seng Thipphavong
  • Erin D. Kennedy
  • Kartik S. JhaveriEmail author
Pictorial essay
Part of the following topical collections:
  1. CME articles



Extramural venous invasion (EMVI) is an independent prognostic factor for prediction of overall unfavorable outcomes in rectal cancer. While EMVI has traditionally been detected in postoperative pathologic specimens, MRI can provide this important piece of information preoperatively. This article reviews the methods of EMVI detection and their clinical implications for treatment and outcomes of rectal cancer.


EMVI has fundamental implications for rectal cancer prognosis and long-term outcomes. Since MRI has the advantage of preoperative detection of EMVI, it has been suggested that MRI-detected EMVI be incorporated for preoperative chemoradiotherapy (CRT) treatment stratification of rectal cancer for better patient triage and outcomes.

Key words

Extramural venous invasion (EMVI) Histopathology MRI Rectal cancer Cancer staging Chemoradiation therapy 


Compliance with Ethical Standards



Disclosure of potential conflicts of interest


Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent



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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Hamideh Ale Ali
    • 1
    • 6
  • Richard Kirsch
    • 2
    • 7
  • Suzan Razaz
    • 1
    • 6
  • Aaditeya Jhaveri
    • 3
    • 8
  • Seng Thipphavong
    • 4
    • 9
  • Erin D. Kennedy
    • 5
    • 7
  • Kartik S. Jhaveri
    • 4
    • 9
    Email author
  1. 1.Joint Department of Medical ImagingUniversity Health NetworkTorontoCanada
  2. 2.Department of Pathology and Laboratory Medicine, Mount Sinai HospitalUniversity of TorontoTorontoCanada
  3. 3.Undergraduate Health Sciences ProgramMcMaster UniversityHamiltonCanada
  4. 4.Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, and Women’s College Hospital, University of TorontoTorontoCanada
  5. 5.Department of Surgery, Mount Sinai HospitalUniversity of TorontoTorontoCanada
  6. 6.TorontoCanada
  7. 7.TorontoCanada
  8. 8.West HamiltonCanada
  9. 9.TorontoCanada

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