MRI of Rectal Cancer: Tumor Staging, Imaging Techniques, and Management

The preoperative imaging diagnosis of rectal cancer lies at the heart of oncological staging and has a crucial influence on patient management and therapy planning. Rectal cancer is common, and accurate preoperative staging of tumors using high-resolution magnetic resonance imaging (MRI) is a crucial part of modern multidisciplinary team management (MDT). Indeed, rectal MRI has the ability to accurately evaluate a number of important findings that maBay impact patient management, including distance of the tumor to the mesorectal fascia, presence of lymph nodes, presence of extramural vascular invasion (EMVI), and involvement of the anterior peritoneal reflection/peritoneum and the sphincter complex. Many of these findings are difficult to assess in non-expert hands. In this chapter, we present currently used staging modalities with focus on MRI, including optimization of imaging techniques, tumor staging, interpretation help as well as essentials for reporting.

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Multimodal Functional Imaging for Cancer/Tumor Microenvironments Based on MRI, EPRI, and PET

Molecules ◽

10.3390/molecules26061614 ◽

2021 ◽

Vol 26 (6) ◽

pp. 1614

Author(s):

Ken-ichiro Matsumoto ◽

James B. Mitchell ◽

Murali C. Krishna

Keyword(s):

Radiation Therapy ◽

Functional Imaging ◽

Imaging Techniques ◽

Biological Effects ◽

Tumor Hypoxia ◽

Redox Status ◽

Blood Oxygen Level Dependent ◽

Oxygen Level ◽

Cancer Tumor

Radiation therapy is one of the main modalities to treat cancer/tumor. The response to radiation therapy, however, can be influenced by physiological and/or pathological conditions in the target tissues, especially by the low partial oxygen pressure and altered redox status in cancer/tumor tissues. Visualizing such cancer/tumor patho-physiological microenvironment would be a useful not only for planning radiotherapy but also to detect cancer/tumor in an earlier stage. Tumor hypoxia could be sensed by positron emission tomography (PET), electron paramagnetic resonance (EPR) oxygen mapping, and in vivo dynamic nuclear polarization (DNP) MRI. Tissue oxygenation could be visualized on a real-time basis by blood oxygen level dependent (BOLD) and/or tissue oxygen level dependent (TOLD) MRI signal. EPR imaging (EPRI) and/or T1-weighted MRI techniques can visualize tissue redox status non-invasively based on paramagnetic and diamagnetic conversions of nitroxyl radical contrast agent. 13C-DNP MRI can visualize glycometabolism of tumor/cancer tissues. Accurate co-registration of those multimodal images could make mechanisms of drug and/or relation of resulted biological effects clear. A multimodal instrument, such as PET-MRI, may have another possibility to link multiple functions. Functional imaging techniques individually developed to date have been converged on the concept of theranostics.

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Radiographic Staging of Colorectal Cancer

10.2310/7800.16027 ◽

2019 ◽

Author(s):

Maurits P. Engbersen ◽

Max J. Lahaye ◽

Regina G.H. Beets-Tan

Keyword(s):

Magnetic Resonance Imaging ◽

Colorectal Cancer ◽

Computed Tomography ◽

Rectal Cancer ◽

Magnetic Resonance ◽

Tumor Staging ◽

Tnm Staging ◽

Preoperative Imaging ◽

Resonance Imaging ◽

Colon And Rectal Cancer

Imaging increasingly plays an important role in selecting the most optimal treatment for patients with colon and rectal cancer. While in colon cancer, computed tomography (CT) remains the modality of choice for local and distant staging, in patients with rectal cancer magnetic resonance imaging (MRI) is the main modality and mandatory for local staging. Endoluminal rectal ultrasound (ERUS) is the preferred staging method for superficial rectal tumors. This chapter addresses the current role of various imaging modalities in colorectal tumor staging. This review contains 4 figures and 50 references. Key words: Preoperative imaging, Colorectal cancer, Magnetic resonance imaging, Diffusion weighted MRI, Computed tomography, Mesorectal fascia, TNM staging, Treatment stratification

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Radiographic Staging of Colorectal Cancer

10.2310/cgso.16027 ◽

2019 ◽

Author(s):

Maurits P. Engbersen ◽

Max J. Lahaye ◽

Regina G.H. Beets-Tan

Keyword(s):

Magnetic Resonance Imaging ◽

Colorectal Cancer ◽

Computed Tomography ◽

Rectal Cancer ◽

Magnetic Resonance ◽

Tumor Staging ◽

Tnm Staging ◽

Preoperative Imaging ◽

Resonance Imaging ◽

Colon And Rectal Cancer

Imaging increasingly plays an important role in selecting the most optimal treatment for patients with colon and rectal cancer. While in colon cancer, computed tomography (CT) remains the modality of choice for local and distant staging, in patients with rectal cancer magnetic resonance imaging (MRI) is the main modality and mandatory for local staging. Endoluminal rectal ultrasound (ERUS) is the preferred staging method for superficial rectal tumors. This chapter addresses the current role of various imaging modalities in colorectal tumor staging. This review contains 4 figures and 50 references. Key words: Preoperative imaging, Colorectal cancer, Magnetic resonance imaging, Diffusion weighted MRI, Computed tomography, Mesorectal fascia, TNM staging, Treatment stratification

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Abdominoperineal Resection for Unexpected Distal Intramural Spreading of Rectal Cancer

Case Reports in Gastroenterology ◽

10.1159/000490043 ◽

2018 ◽

Vol 12 (2) ◽

pp. 297-302 ◽

Cited By ~ 1

Author(s):

Shinya Munakata ◽

Yuta Murai ◽

Akihiro Koizumi ◽

Hisaki Kato ◽

Riku Yamamoto ◽

...

Keyword(s):

Rectal Cancer ◽

Lymph Node ◽

Abdominoperineal Resection ◽

Frozen Section ◽

Advanced Rectal Cancer ◽

Malignant Cell ◽

Maximum Extent ◽

Old Japanese ◽

Cancer Tumor ◽

Virchow’S Node

Introduction: In rectal cancer, distal intramural spread may sometimes occur, but a maximum extent of distal spread of > 6 cm is very rare. Case Presentation: A 65-year-old Japanese male with an advanced rectal cancer tumor with para-aortic lymph node metastasis was admitted. We performed a low anterior resection with lymphadenectomy, but the intraoperative frozen-section analysis of margins revealed malignant cell positivity; we, therefore, performed an abdominoperineal resection. Pathological findings showed that the maximum extent of distal spread was 6 cm. After 12 courses of FOLFOX4 as adjuvant chemotherapy, abdominal computed tomography revealed whole lymph node metastases, including Virchow’s node. Though FOLFIRI + panitumumab was started, he was not eligible for additional chemotherapy after 10 cycles. Conclusion: An intraoperative frozen pathology examination was helpful for the additional resection, when unexpected distal spreading had occurred in rectal cancer. The evidence of a distal negative margin should not be underestimated.

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Novel imaging techniques of rectal cancer: what do radiomics and radiogenomics have to offer? A literature review

Abdominal Radiology ◽

10.1007/s00261-019-02042-y ◽

2019 ◽

Vol 44 (11) ◽

pp. 3764-3774 ◽

Cited By ~ 15

Author(s):

Natally Horvat ◽

David D. B. Bates ◽

Iva Petkovska

Keyword(s):

Rectal Cancer ◽

Literature Review ◽

Imaging Techniques

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A Literature Survey on Early Detection of Malignant Tumor Through Computerized Technique

Journal of Computational and Theoretical Nanoscience ◽

10.1166/jctn.2020.8977 ◽

2020 ◽

Vol 17 (9) ◽

pp. 3873-3877

Author(s):

S. V. Shwetha ◽

L. Dharmanna

Keyword(s):

Detection System ◽

Imaging Techniques ◽

Research Work ◽

Texture Feature ◽

Statistical Parameters ◽

Transformation Ratio ◽

Initial Stage ◽

Stage Classification ◽

Cancer Tumor ◽

Computer Based

Computer based initial stage classification and detection of breast cancer tumor must be taken as one of the most important parameter to detect cancer in order to assist radiologist. In this paper an overview of current development of computer based detection system has been reviewed. The abnormalities identification and classification based on texture feature and shape of tumor, statistically diagnostic parameters (mean, mode, standard deviation, median etc.), Entropy based, Elliptical Normalized Circumference (ENC), C-means, K-means, Watershed Transformation, Ratio of Perimeter:Area (P :A), Ratio of major axis:minor axis (L:S) and Content Based Image Retrieval (CBIR) have been presented. In this paper the accuracy of the result obtained by various techniques such as texture based classification (80%), statistical parameters based classification (70%), shape based classification (86%), CBIR based classification (60%), etc. are presented. The various imaging techniques and dedicated databases publicly available for the cancer research work have been listed, discussed and reported in this paper.

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Progress in Rectal Cancer Treatment

ISRN Gastroenterology ◽

10.5402/2012/648183 ◽

2012 ◽

Vol 2012 ◽

pp. 1-15 ◽

Cited By ~ 5

Author(s):

Wim P. Ceelen

Keyword(s):

Rectal Cancer ◽

Neoadjuvant Therapy ◽

Imaging Techniques ◽

Dramatic Improvement ◽

Term Outcome ◽

Long Term Outcome ◽

Number Of Patients ◽

Systemic Relapse ◽

Selection Of Patients ◽

Selection Of

The dramatic improvement in local control of rectal cancer observed during the last decades is to be attributed to attention to surgical technique and to the introduction of neoadjuvant therapy regimens. Nevertheless, systemic relapse remains frequent and is currently insufficiently addressed. Intensification of neoadjuvant therapy by incorporating chemotherapy with or without targeted agents before the start of (chemo)radiation or during the waiting period to surgery may present an opportunity to improve overall survival. An increasing number of patients can nowadays undergo sphincter preserving surgery. In selected patients, local excision or even a “wait and see” approach may be feasible following active neoadjuvant therapy. Molecular and genetic biomarkers as well as innovative imaging techniques may in the future allow better selection of patients for this treatment option. Controversy persists concerning the selection of patients for adjuvant chemotherapy and/or targeted therapy after neoadjuvant regimens. The currently available evidence suggests that in complete pathological responders long-term outcome is excellent and adjuvant therapy may be omitted. The results of ongoing trials will help to establish the ideal tailored approach in resectable rectal cancer.

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Magnetic Resonance Imaging of Rectal Cancer

Journal of Gastrointestinal and Abdominal Radiology ◽

10.1055/s-0039-1683772 ◽

2019 ◽

Vol 02 (01) ◽

pp. 018-032

Author(s):

Ekta Maheshwari ◽

Gitanjali Bajaj ◽

Kedar Jambhekar ◽

Tarun Pandey ◽

Roopa Ram

Keyword(s):

Magnetic Resonance Imaging ◽

Rectal Cancer ◽

Magnetic Resonance ◽

High Resolution ◽

Imaging Techniques ◽

Postoperative Recurrence ◽

Response To Therapy ◽

Resonance Imaging ◽

Primary Rectal Cancer ◽

Magnetic Resonance Imaging Mri

AbstractHigh-resolution magnetic resonance imaging (MRI) plays a pivotal role in the pretreatment assessment of primary rectal cancer. The success of this technique depends on obtaining good-quality high-resolution T2-weighted images of the primary tumor, orthogonal to rectal lumen. The goal of magnetic resonance staging is to identify patients who will benefit from neoadjuvant therapy prior to surgery to minimize postoperative recurrence and planning of optimal surgical approach. MRI also facilitates optimal identification of important prognostic factors, which improves both treatment selection and posttreatment follow-up. The objective of this article is to review the existing literature and provide a concise update on various aspects of rectal cancer imaging, discuss the current role of advanced imaging techniques such as diffusion-weighted and perfusion imaging in the evaluation of rectal cancer, and to assess response to therapy.

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