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Diffusion Weighted Imaging of the Gastrointestinal Tract

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Abstract

DWI is increasingly adopted in clinical MRI protocols as a beneficial adjunct to morphological (T2-weighted) sequences for the staging and in particular for the restaging of rectal cancer. There is growing evidence that DWI can help evaluate the response of rectal tumours to neoadjuvant chemoradiotherapy and differentiate viable residual tumour within areas of post-radiation fibrosis. Moreover, the high sensitivity of DWI may aid in detecting small (recurrent) tumours and lymph nodes, although the value of DWI to differentiate between benign/reactive and metastatic lymph nodes appears to be limited. There is some evidence that DWI holds promise as a biomarker to predict treatment outcome and prognosis, although results so far have been inconsistent and will need to be validated by further studies.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the (ROC) curve

CRT:

Chemoradiotherapy

DWI:

Diffusion-weighted (magnetic resonance) imaging

EPI:

Echo planar imaging

MRF:

Mesorectal fascia

MRI:

Magnetic resonance imaging

N-stage:

Nodal stage

T-stage:

Tumour stage

TME:

Total mesorectal excision

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Author information

Authors and Affiliations

  1. Department of Radiology, The Netherlands Cancer Institute, Amsterdam, Netherlands

    Doenja M. J. Lambregts & Regina G. H. Beets-Tan

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  1. Doenja M. J. Lambregts
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  2. Regina G. H. Beets-Tan
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Correspondence to Doenja M. J. Lambregts .

Editor information

Editors and Affiliations

  1. Department of Radiology, Konstantopouleio General Hospital, Athens, Greece

    Sofia Gourtsoyianni

  2. Head of Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal

    Nikolaos Papanikolaou

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Lambregts, D.M.J., Beets-Tan, R.G.H. (2019). Rectum. In: Gourtsoyianni, S., Papanikolaou, N. (eds) Diffusion Weighted Imaging of the Gastrointestinal Tract. Springer, Cham. https://doi.org/10.1007/978-3-319-92819-7_5

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  • DOI: https://doi.org/10.1007/978-3-319-92819-7_5

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