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Clin Colon Rectal Surg 2008; 21(3): 178-187
DOI: 10.1055/s-2008-1080997
© Thieme Medical Publishers

Magnetic Resonance Imaging of Rectal Cancer

Mai-Lan Ho1 , Judy Liu2 , Vamsidhar Narra2
  • 1Washington University School of Medicine, St. Louis, Missouri
  • 2Abdominal Radiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
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Publication History

Publication Date:
24 July 2008 (online)

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ABSTRACT

Magnetic resonance imaging (MRI)is a useful modality for the evaluation of rectal cancer, providing superior anatomic/pathologic visualization when compared with endorectal ultrasound (EUS) and computed tomography (CT). Preoperative MRI is useful for tissue characterization and tumor staging, which determines the surgical approach and need for neoadjuvant/adjuvant therapy. Important prognostic factors include the circumferential resection margin (CRM), T and N stages, and extent of local invasion. Postoperative MRI to assess the extent of tumor recurrence enables early resection, which can greatly prolong survival. MRI criteria for local recurrence include T2 hyperintensity, early dynamic rim enhancement, and nodular morphology. Future research in MRI of rectal cancer is geared toward developing optimal imaging techniques including high-resolution MRI, whole-body scans, and parallel imaging; imaging of lymph nodes by MR lymphography; and response to therapy using diffusion/perfusion-weighted MR and functional imaging.

KEYWORDS

Magnetic resonance - rectal cancer - preoperative - postoperative - recurrence

REFERENCES

  • 1 Hussain S M, Outwater E K, Siegelman E S. Mucinous versus nonmucinous rectal carcinomas: differentiation with MR imaging.  Radiology. 1999;  213(1) 79-85
    PubMedSearch in Google Scholar
  • 2 Beets-Tan R G, Beets G L. Rectal cancer: review with emphasis on MR imaging.  Radiology. 2004;  232(2) 335-346
    PubMedSearch in Google Scholar
  • 3 Klessen C, Rogalla P, Taupitz M. Local staging of rectal cancer: the current role of MRI.  Eur J Radiol. 2007;  17(2) 379-389
    CrossrefPubMedSearch in Google Scholar
  • 4 Iafrate F, Laghi A, Paolantonio P et al.. Preoperative staging of rectal cancer with MR imaging: correlation with surgical and histopathologic findings.  Radiographics. 2006;  26(3) 701-714
    CrossrefPubMedSearch in Google Scholar
  • 5 Lahaye M J, Lamers W H, Beets G L, Beets-Tan R GH. MR Anatomy of the rectum and the mesorectum. In: Di Falco G, Santoro GA Benign Anorectal Diseases: Diagnosis with Endoanal and Endorectal Ultrasound and New Treatment Options. New York, NY; Springer 2006: 67-77
    Search in Google Scholar
  • 6 Sahani D V, Kalva S P, Hahn P F. Imaging of rectal cancer.  Semin Radiat Oncol. 2003;  13(4) 389-402
    CrossrefPubMedSearch in Google Scholar
  • 7 Dobos N, Rubesin S E. Radiologic imaging modalities in the diagnosis and management of colorectal cancer.  Hematol Oncol Clin North Am. 2002;  16(4) 875-895
    CrossrefPubMedSearch in Google Scholar
  • 8 Vliegen R F, Beets G L, von Meyenfeldt M F et al.. Rectal cancer: MR imaging in local staging–is gadolinium-based contrast material helpful?.  Radiology. 2005;  234(1) 179-188
    CrossrefPubMedSearch in Google Scholar
  • 9 Wallengren N O, Holtas S, Andren-Sandberg A, Jonsson E, Kristoffersson D T, McGill S. Rectal carcinoma: double-contrast MR imaging for preoperative staging.  Radiology. 2000;  215(1) 108-114
    PubMedSearch in Google Scholar
  • 10 Elmas N, Killi R M, Sever A, Klessen C, Rogalla P, Taupitz M. Colorectal carcinoma: radiological diagnosis and staging.  Eur J Radiol. 2002;  42(3) 206-223
    CrossrefPubMedSearch in Google Scholar
  • 11 Goh V, Halligan S, Bartram C I. Local radiological staging of rectal cancer.  Clin Radiol. 2004;  59(3) 215-226
    CrossrefPubMedSearch in Google Scholar
  • 12 Maier A, Fuchsjager M. Preoperative staging of rectal cancer.  Eur J Radiol. 2003;  47(2) 89-97
    CrossrefPubMedSearch in Google Scholar
  • 13 Moran B, Brown G, Cunningham D, Daniels I, Heald R, Quirke P, Sebag-Montefiore D. Clarifying the TNM staging of rectal cancer in the context of modern imaging and neo-adjuvant treatment: ‘y' ‘u’ and ‘p’ need ‘mr’ and ‘ct’.  Colorectal Dis. 2008;  10(3) 242-243
    CrossrefPubMedSearch in Google Scholar
  • 14 Hoeffel C, Arrivé L, Mourra N, Azizi L, Lewin M, Tubiana J M. Anatomic and pathologic findings at external phased-array pelvic MR imaging after surgery for anorectal disease.  Radiographics. 2006;  26(5) 1391-1407
    CrossrefPubMedSearch in Google Scholar
  • 15 Messiou C, Chalmers A, Boyle K, Sagar P. Surgery for recurrent rectal carcinoma: The role of preoperative magnetic resonance imaging.  Clin Radiol. 2006;  61(3) 250-258
    CrossrefPubMedSearch in Google Scholar
  • 16 Tan P L, Chan C L, Moore N R. Radiological appearances in the pelvis following rectal cancer surgery.  Clin Radiol. 2005;  60(8) 846-855
    CrossrefPubMedSearch in Google Scholar
  • 17 Brown G, Richards C J, Newcombe R G et al.. Rectal carcinoma: thin-section MR imaging for staging in 28 patients.  Radiology. 1999;  211(1) 215-222
    PubMedSearch in Google Scholar
  • 18 Barrett T, Kobayashi H, Brechbiel M, Choyke P L. Macromolecular MRI contrast agents for imaging tumor angiogenesis.  Eur J Radiol. 2006;  60(3) 353-366
    CrossrefPubMedSearch in Google Scholar
  • 19 Zahra M A, Hollingsworth K G, Sala E, Lomas D J, Tan L T. Dynamic contrast-enhanced MRI as a predictor of tumour response to radiotherapy.  Lancet Oncol. 2007;  8(1) 63-74
    CrossrefPubMedSearch in Google Scholar

Vamsidhar NarraM.D. 

Mallinckrodt Institute of Radiology, Washington University School of Medicine

Campus Box 8131, St. Louis, MO 63110

Email: narrav@wustl.edu