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

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Abstract

Objective

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.

Conclusion

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.

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Authors and Affiliations

  1. Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada

    Hamideh Ale Ali & Suzan Razaz

  2. Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada

    Richard Kirsch

  3. Undergraduate Health Sciences Program, McMaster University, Hamilton, ON, Canada

    Aaditeya Jhaveri

  4. Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, and Women’s College Hospital, University of Toronto, Toronto, ON, Canada

    Seng Thipphavong & Kartik S. Jhaveri

  5. Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada

    Erin D. Kennedy

  6. 700 University Avenue, 2nd floor north, Toronto, ON, M5G 1X5, Canada

    Hamideh Ale Ali & Suzan Razaz

  7. 600 University Avenue, Mount Sinai Hospital, Toronto, ON, M5G 1X5, Canada

    Richard Kirsch & Erin D. Kennedy

  8. 1280 Main Street, West Hamilton, ON, L8S 4L8, Canada

    Aaditeya Jhaveri

  9. 610 University Ave, 3-957, Toronto, ON, M5G 2M9, Canada

    Seng Thipphavong & Kartik S. Jhaveri

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  1. Hamideh Ale Ali
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Correspondence to Kartik S. Jhaveri.

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Ale Ali, H., Kirsch, R., Razaz, S. et al. Extramural venous invasion in rectal cancer: overview of imaging, histopathology, and clinical implications. Abdom Radiol 44, 1–10 (2019). https://doi.org/10.1007/s00261-018-1673-2

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