On the role of radiologists in the Belgian PROject on CAncer of the REctum, PROCARE.
Radiologists are involved at all stages of the treatment of patients with rectum cancer: in the preoperative staging, in the diagnosis of postoperative complications, in the detection of recurrent or metastatic disease during follow-up, in the monitoring of the therapeutic effect of palliative therapy. PROCARE is a Belgian national project to improve outcome in all patients with rectum cancer. Guidelines were made by a multidisciplinary workgroup and are available on the web. Decentralised implementation of guidelines is organised by the scientific and professional organisations. It is planned that a central review committee of radiologists, delegated by the Royal Belgian Society of Radiology, will survey the quality of preoperative staging. Overall quality of care will be assured by registration in a specific national database starting in 2006. Participating teams will receive annual feedback. Radiologists should provide data on cTNM staging and cCRM. Differentiation between cT2 and cT3, cN0 and cN+, and measurement of the cCRM in mm are crucial as they have a relevant impact on treatment strategy. While spiral abdominal CT is adequate for cM staging, high-resolution MRI is highly recommended and, in fact, a necessity for locoregional staging because its adequacy is superior to that of CT-scan and EUS. However, EUS is mandatory when local excision is considered, i.e. for cT1N0 lesions.
Penninckx
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F
Department of Abdominal Surgery, UZ Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
Danse
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E
D001530:Belgium; D019992:Databases as Topic; D019160:Endosonography; D005246:Feedback; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009313:National Health Programs; D009362:Neoplasm Metastasis / Q000175:diagnosis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D010166:Palliative Care; D011183:Postoperative Complications / Q000175:diagnosis; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D011871:Radiology; D012004:Rectal Neoplasms / Q000628:therapy*; D012955:Societies, Medical; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome