Preoperative staging of rectal cancer by MRI; results of a UK survey.
OBJECTIVE
To determine current day-to-day practice of and access to preoperative MRI for patients with rectal cancer in the UK, with the aim of identifying constraining factors.


METHODS
A questionnaire asking for details of rectal cancer workload, multidisciplinary team (MDT) practice, preoperative MRI, the use of alternative imaging methods where appropriate, and an assessment of local access to MRI, was mailed to 283 UK departments of radiology. Replies were received from 142 departments (50.2% response rate). These were collated and response frequencies were determined.


RESULTS
According to their replies, 135 (95%) of respondents always discussed rectal cancer cases within the context of an MDT, usually including a radiologist. Only 49% of respondents attempted to offer preoperative MRI to all rectal cancer patients, and 35% of respondents used MRI in less than 25% of cases. Of the 142 respondents, 73 (51%) felt their practice was currently constrained by lack of MR resources. The most frequently cited constraint was an available but over-subscribed MRI scanner. Limited radiology manpower was the next most frequently cited constraint. A significant minority stated that no MRI scanner was available.


CONCLUSIONS
The MDT is a well established forum for the discussion of patients with rectal cancer, and a radiologist is usually involved. However, in the face of current guidelines, less than 50% of the units studied were able to offer preoperative MRI to all of their rectal cancer cases. Improved access to MRI and increased radiological manpower are necessary if current management guidelines are to be observed.
Taylor
A
A
Department of Radiology, Royal Lancaster Infirmary, Lancaster, UK. alasdair.taylor@rli.mbht.nhs.uk
Sheridan
M
M
McGee
S
S
Halligan
S
S
D019538:Health Care Surveys; D006302:Health Services Research; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D009367:Neoplasm Staging; D010348:Patient Care Team / Q000458:organization & administration; D011300:Preoperative Care / Q000379:methods*; D011872:Radiology Department, Hospital / Q000458:organization & administration; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D011795:Surveys and Questionnaires; D006113:United Kingdom; D016526:Workload / Q000706:statistics & numerical data