title: Magnetic resonance imaging and endorectal ultrasound for diagnosis of rectal lesions.
abstract: Endorectal ultrasonography (ERUS) and magnetic resonance imaging (MRI) allow exploring the morphology of the rectum in detail. Use of such data, especially assessment of the rectal wall, is an important tool for ascertaining the perianal fistula localization as well as stage of the cancer and planning it appropriate treatment, as stage T3 tumors are usually treated with neoadjuvant therapy, whereas T2 tumors are initially managed surgically. The only advantage of ERUS over MRI is the possibility of assessing T1 tumors that could be treated by transanal endoscopic microsurgery. However, MRI is better for visualizing most radiological prognostic features in rectal or anal cancer such as a circumferential resection margin less than 1 mm, T stage at T1-T2 or T3 tumors with extramural extension less than 5 mm, absence of extramural vascular invasion, N stage at N0/N1, and tumors located in the middle or upper third of the rectum. It can also evaluate the intersphincteric space or levator ani muscle involvement. Increased signal on diffusion weighted imaging (DWI) and low apparent diffusion coefficient (ADC) values as well as an irregular contour and heterogeneous internal signal intensity seem to predict the involvement of pelvic lymphatic nodes better than their size alone. Computed tomography as well as other examination techniques, including digital rectal examination, contrast edema, recto- and colonoscopy, are less useful in staging of rectal cancer but still are very important screening tools.
authors.affiliation: St. John's Cancer Centre, 7 Jaczewskiego Str., 20-090, Lublin, Poland. fb3@wp.pl.|Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego Str., 20-090, Lublin, Poland. fb3@wp.pl.
authors.forename: Franciszek
authors.initials: F
authors.lastname: Burdan
authors.affiliation: Department of Radiology, Institute of Rheumatology, 1 Spartanska Str., 02-637, Warsaw, Poland. sudolszopinska@gmail.com.|Department of Diagnostic Imaging, Second Faculty of Medicine, Medical University of Warsaw, 8 Kondratowicza Str., 03-242, Warsaw, Poland. sudolszopinska@gmail.com.
authors.forename: Iwona
authors.initials: I
authors.lastname: Sudol-Szopinska
authors.affiliation: St. John's Cancer Centre, 7 Jaczewskiego Str., 20-090, Lublin, Poland. cozl@cozl.eu.
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Staroslawska
authors.affiliation: Department of Proctology, Hospital at Solec, 93 Solec Str., 00-382, Warsaw, Poland. drkolodziejczak@o2.pl.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Kolodziejczak
authors.affiliation: Department of Clinical Pathomorphology, Medical University of Lublin, 1 Ceramiczna Str., 20-059, Lublin, Poland. rklepacz@wp.pl.
authors.forename: Robert
authors.initials: R
authors.lastname: Klepacz
authors.affiliation: St. John's Cancer Centre, 7 Jaczewskiego Str., 20-090, Lublin, Poland. amo22@interia.pl.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Mocarska
authors.affiliation: St. John's Cancer Centre, 7 Jaczewskiego Str., 20-090, Lublin, Poland. marekc@lublin.net.pl.
authors.forename: Marek
authors.initials: M
authors.lastname: Caban
authors.affiliation: St. John's Cancer Centre, 7 Jaczewskiego Str., 20-090, Lublin, Poland. iwona5627@wp.pl.
authors.forename: Iwonna
authors.initials: I
authors.lastname: Zelazowska-Cieslinska
authors.affiliation: Department of Clinical Pathomorphology, Medical University of Lublin, 1 Ceramiczna Str., 20-059, Lublin, Poland. jszumilo@wp.plx.
authors.forename: Justyna
authors.initials: J
authors.lastname: Szumilo
mesh_terms: D019160:Endosonography / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D012003:Rectal Fistula / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging