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Magnetic Resonance Imaging in Benign and Malignant Rectal Neoplasms

  • Pedro C. Basilio
  • Alice Brandão
  • Rosilma Gorete Lima Barreto

Abstract

Magnetic resonance imaging (MRI) is an accurate method for preoperative rectal cancer staging. The similarity with anatomy provides surgeons a clear view of local regional rectal cancer spread. Information detected through MRI is important to carefully plan adequate surgical management for each particular rectal cancer case. Data on cancer local status before neoadjuvant chemoradiation can be compared with posttreatment status to evaluate the magnitude of downstaging. Lymph node status should also be studied and taken into consideration whenever surgical treatment for rectal cancer is indicated, even before the number and lymph node volume regression occurs as a result of preoperative treatment regimens. Images acquired after neoadjuvant treatment are equally important to define surgical strategy. Imaging techniques and incidences as well as their surgical implications are contemplated in this chapter.

Keywords

Rectal Cancer Total Mesorectal Excision Circumferential Resection Margin Resolution Magnetic Resonance Imaging Pelvic Side Wall 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Ministério da Saúde (2006) Instituto Nacional de Cancer. Estimativa de Cancer no Brasil. www.inca.org.br/estimativa/2006. Cited 23 Sep 2007Google Scholar
  2. 2.
    National Cancer Institute (2007). Estimated new cases and death for rectal cancer 2007. www.cancer.gov/cancertopics/types/colon-and-rectal. Cited 29 Sep 2007Google Scholar
  3. 3.
    Corman ML (1998) Carcinoma of the colon. In: Corman ML (ed). Colon and rectal surgery, 4th edn. Lippincott-Raven, PhiladelphiaGoogle Scholar
  4. 4.
    Cohen AM, Winaver SJ Friedman, MA, Gunderson LL (1995) Cancer of the colon rectum and anus. McGraw-Hill, New YorkGoogle Scholar
  5. 5.
    Fleming ID, ed (1997) American Joint Committee on Cancer, American Cancer Society, American College of Surgeons. AJCC cancer staging manual, 5th edn. Lippincott-Raven, PhiladelphiaGoogle Scholar
  6. 6.
    Wieder HA, Rosenberg R, Lordick F et al (2007) Rectal cancer: MRI before neoadjuvant chemotherapy and radiation for prediction of tumor-free circumferential resection margins and long-term survival. Radiology 243:744–751PubMedCrossRefGoogle Scholar
  7. 7.
    Klessen C, Rogalla P, Taupitz M (2007) Local staging of rectal cancer: the current role of MRI. Eur Radiol 17(2):379–389PubMedCrossRefGoogle Scholar

References

  1. 1.
    Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet i:1479–1482CrossRefGoogle Scholar
  2. 2.
    Quirke P, Durdey P, Dixon MF, Williams NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection: histopathological study of lateral tumour spread and surgical excision. Lancet ii:996–999CrossRefGoogle Scholar
  3. 3.
    Dahlberg M, Stenbourg A, Pahlman L, Glimelius B, Swedish Rectal Cancer Trial (2002) Cost-effectiveness of preoperative radiotherapy in rectal cancer: results for the Swedish Rectal Cancer Trial. Int J Radiat Oncol Biol Phys 54:654–660PubMedGoogle Scholar
  4. 4.
    Polglase AL, McMurrick PJ, Tremayne AP, Bhathal PS (2001) Local recurrence after curative anterior resection with principally blunt dissection for carcinoma of the rectum and rectosigmoid. Dis Colon Rectum 44:947–954PubMedCrossRefGoogle Scholar
  5. 5.
    Heald RJ, Moran BJ, Ryall RD et al (1998) Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978–1997. Arch Surg 133:894–899PubMedCrossRefGoogle Scholar
  6. 6.
    Chiappa A, Biffi R, Zbar AP et al (2005) Results of treatment of distal rectal carcinoma since the introduction of total mesorectal excision: a single unit experience, 1994–2003. Int J Colorect Dis 20:221–230CrossRefGoogle Scholar
  7. 7.
    Martling AL, Holm T, Rutqvist LE (2000) Effect of a surgical training programme on outcome of rectal cancer in the County of Stockholm. Stockholm Colorectal Cancer Study Group, Basingstoke Bowel Cancer Research Project. Lancet 356:93–96PubMedCrossRefGoogle Scholar
  8. 8.
    Hermanek P (1999) Impact of surgeon’s technique on outcome after treatment of rectal carcinoma. Dis Colon Rectum 42:559–562PubMedCrossRefGoogle Scholar
  9. 9.
    Beets-Tan RG, Beets GL, Vliegen RF et al (2001) Accuracy of magnetic resonance imaging in prediction of tumour-free resection margin in rectal cancer surgery. Lancet 357(9255):497–504PubMedCrossRefGoogle Scholar
  10. 10.
    Brown G, Radcliffe AG, Newcombe RG et al (2003) Preoperative assessment of prognostic factors in rectal cancer using high-resolution magnetic resonance imaging. Br J Surg 90:355–64PubMedCrossRefGoogle Scholar
  11. 11.
    Brown G, Zbar AP (2005) MRI in colorectal surgery: surface magnetic resonance imaging in anorectal practice. In: Complex anorectal disorders: investigation and management. Wexner SD, Zbar AP, Pescatori M (eds) Springer-Verlag, Berlin pp 275–297CrossRefGoogle Scholar
  12. 12.
    Kim MJ, Park JS, Park SI et al (2003) Accuracy in differentiation of mucinous and non-mucinous rectal carcinoma on MR imaging. J Comput Assit Tomogr 27:48–55CrossRefGoogle Scholar
  13. 13.
    Bissett IP, Fernando CC, Hough DM et al (2001) Identification of the fascia propria by magnetic resonance imaging and its relevance to preoperative assessment of rectal cancer. Dis Colon Rectum 44:259–265PubMedCrossRefGoogle Scholar
  14. 14.
    Kremser C, Judmaier W, Hein P et al (2003) Preliminary results on the influence of chemoradiation on apparent diffusion coefficients of primary rectal carcinoma measured by magnetic resonance imaging. Strahlenther Onkol 179:641–649PubMedCrossRefGoogle Scholar
  15. 15.
    Watanabe T, Tsurita G, Muto T et al (2002) Extended lymphadenectomy and preoperative radiotherapy for lower rectal cancers. Surgery 132:27–33PubMedCrossRefGoogle Scholar
  16. 16.
    Brown G, Richards CJ, Bourne NW et al (2003) Morphologic predictors of lymph node status in rectal cancer with use of high-spatial-resolution MR imaging with histopathologic comparison. Radiology 227:371–377PubMedCrossRefGoogle Scholar
  17. 17.
    Robinson P, Carrington BM, Swindell R et al (2002) Recurrence or residual pelvic bowel cancer: accuracy of MRI local extent before salvage surgery. Clin Radiol 57:514–522PubMedCrossRefGoogle Scholar
  18. 18.
    Torricelli P, Pecchi A, Luppi G, Romagnoli R (2003) Gadolinium-enhanced MRI with dynamic evaluation in diagnosing local recurrence of rectal cancer. Abdom Imaging 28:19–27PubMedCrossRefGoogle Scholar
  19. 19.
    Brown G, Daniels IR (2005) Preoperative staging of rectal cancer: the MERCURY research project. Recent results. Cancer Res 165:58–74Google Scholar
  20. 20.
    Salerno G, Daniels IR, Moran et al (2006) Clarifying margins in the multidisciplinary management of rectal cancer: the MERCURY experience. Clin Radiol 61:916–923PubMedCrossRefGoogle Scholar
  21. 21.
    MERCURY Study Group (2007) Extramural depth of tumor invasion at thin-section MR in patients with rectal cancer: results of the MERCURY study. Radiology 243:132–139CrossRefGoogle Scholar
  22. 22.
    Marr R, Birbeck K, Garvican J et al (2005) The modern abdominoperineal excision. The next challenge after total mesorectal excision. Ann Surg 242:74–82PubMedCrossRefGoogle Scholar
  23. 23.
    Daniels IR, Strassburg J, Moran BJ (2006) The need for future surgical low rectal cancer studies. Colorectal Dis 8(Suppl 3):25–29PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Pedro C. Basilio
    • 1
  • Alice Brandão
    • 2
  • Rosilma Gorete Lima Barreto
    • 3
  1. 1.Section of Colégio Brasileiro de Cirurgiões — CBC, and Colorectal SurgeryHospital SamaritanoRio de Janeiro, RJBrazil
  2. 2.Clínica RadiológicaLuiz Felippe MattosoRio de Janeiro, RJBrazil
  3. 3.Medical School of the FederalUniversity of CearaSão Luis, MaranhãoBrazil

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