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MRI of Rectal Cancer pp 25–54Cite as

Magnetic Resonance Imaging of Rectal Cancer

From Current Facts to Future Perspectives

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Abstract

Understanding the nature of rectal cancer is a dynamic process. The significance of imaging in relation to the interaction of treatment and individual prognosis is constantly evolving. Although specialized rectal cancer surgery offers the most probable chance of cure, the contribution of neoadjuvant chemoradiation to the reduction of local recurrence rates and improved patient survival is increasingly realized. To this end, magnetic resonance imaging (MRI) is frequently used to select patients for neoadjuvant chemoradiation and to predict a tumor-free circumferential resection plane at surgery. Current state-of-the-art pelvic MRI consistently depicts the mesorectal fascia. By definition, if a tumor lies within 1 mm of this fascia, then the surgical resection margin is deemed to be involved. Hence, MRI strongly supports the identification of patients who are at high risk of oncologically incomplete resection. Selecting these patients prior to surgery allows for the addition of preoperative chemoradiation therapy (Koh et al. 2006). MRI for rectal cancer has emerged as the first-line imaging tool for multidisciplinary team (MDT) decisions. The adoption of new concepts such as moving-table MRI for the assessment of metastatic spread and diffusion-weighted imaging (DWI) will further strengthen the role of MRI as a “one-stop-shop” staging procedure. Although MRI can provide a broad overview of the extent of the disease, but it may also make diagnosis more complex. A radiologist who specializes in pelvic MRI must be familiar with the principles of recent imaging techniques, as well as with characteristic imaging findings associated with rectal cancer. This chapter provides a summary of current clinical practice regarding pelvic MRI at 1.5 T for staging of rectal cancer.

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Schäfer, AO. (2009). Magnetic Resonance Imaging of Rectal Cancer. In: MRI of Rectal Cancer. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-72833-7_4

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