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Magnetic resonance imaging in rectal cancer: A surgeon’s perspective

Authors
 Avanish P Saklani  ;  Sung Uk Bae  ;  Amy Clayton  ;  Nam Kyu Kim 
Citation
 WORLD JOURNAL OF GASTROENTEROLOGY, Vol.20(8) : 2030-2041, 2014 
Journal Title
WORLD JOURNAL OF GASTROENTEROLOGY
ISSN
 1007-9327 
Issue Date
2014
MeSH
Chemoradiotherapy ; Diffusion Magnetic Resonance Imaging ; Ferric Compounds/chemistry ; Humans ; Magnetic Resonance Imaging* ; Neoadjuvant Therapy ; Neoplasm Staging ; Rectal Neoplasms/pathology* ; Rectal Neoplasms/surgery* ; Reproducibility of Results ; Treatment Outcome
Keywords
Magnetic resonance imaging ; Rectal cancer ; Surgeon
Abstract
Magnetic resonance imaging (MRI) in rectal cancer was first investigated in 1999 and has become almost mandatory in planning rectal cancer treatment. MRI has a high accuracy in predicting circumferential resection margin involvement and is used to plan neoadjuvant therapy. The accuracy of MRI in assessing mesorectal lymph nodes remains moderate, as there are no reliable criteria to assess nodal involvement. MRI seems to be good in assessing peritoneal involvement in upper rectal cancer; this however has been assessed in only a few studies and needs further research. For low rectal cancers, mesorectum is thin at the level of levator ani especially in relation to prostate; so predicting circumferential resection margin involvement is not easy. However high spatial resolution coronal imaging shows levator muscles, sphincter complex and intersphincteric plane accurately. This is used to stage low rectal tumors and plan plane of surgery (standard surgery, intersphincteric resection, Extralevator abdominoperineal resection). While most centres perform MRI post chemoradiotherapy, its role in accurate staging post neoadjuvant therapy remains debatable. THe role of Diffusion weighted MRI post neoadjuvant therapy is being evaluated in research settings.
Files in This Item:
T201403715.pdf Download
DOI
10.3748/wjg.v20.i8.2030
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Bae, Sung Uk(배성욱)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100165
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