title: Optimal Imaging Strategies for Rectal Cancer Staging and Ongoing Management.
abstract: Imaging determines the optimal treatment for rectal cancer patients. High-resolution magnetic resonance imaging (MRI) overcomes many of the known limitations of previous methods. When performed in accordance with the recommended standards, MRI enables accurate staging of both early and advanced rectal cancer, accurate response assessment, the delineation of recurrent disease and planning surgical treatment in a safe and effective manner. Tumour-related high-risk features with known adverse outcomes can be preoperatively identified and treated with neoadjuvant chemoradiotherapy. Further, MRI post-treatment tumour response assessment using TRG grading system also predicts the likely survival outcomes and in the future will be used to modify treatment further by stratification into good and poor responders. There is a paucity of literature with validated outcome data concerning use of diffusion-weighted imaging and positron emission tomography (PET)/computed tomography (CT), and in the absence of any validated methods and outcome data, their use in the initial assessment and restaging after treatment is limited to research protocols. Combination MRI and CT is essential for distant spread assessment and recurrent disease, and currently PET-CT is sometimes used in the workup of patients with recurrent and metastatic disease.
authors.affiliation: Colorectal Imaging Group, The Royal Marsden Hospital, NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK.|Imperial College London, London, UK.|The N.N. Blokhin Cancer Research Center, Kashirskoye Shosse 24, 15478, Moscow, Russia.|The National Scientific Center of Coloproctology, ul. Saliama Adilia 2, 123423, Moscow, Russia.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Balyasnikova
authors.affiliation: Colorectal Imaging Group, The Royal Marsden Hospital, NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK. gina.brown@rmh.nhs.uk.|Imperial College London, London, UK. gina.brown@rmh.nhs.uk.
authors.forename: Gina
authors.initials: G
authors.lastname: Brown
mesh_terms: D019468:Disease Management; D006801:Humans; D008279:Magnetic Resonance Imaging; D064847:Multimodal Imaging / Q000379:methods; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D061848:Optical Imaging / Q000379:methods; D000072078:Positron Emission Tomography Computed Tomography; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D012008:Recurrence; D014057:Tomography, X-Ray Computed
keywords: CRM; EMVI; ERUS; Early and advanced rectal cancer; High-resolution MRI; N stage; PET/CT; Rectal cancer staging; Recurrent and mucinous rectal cancer; Response assessment; T stage