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Restaging of Rectal Cancer with MR Imaging after Concurrent Chemotherapy and Radiation Therapy

 Dae Jung Kim  ;  Joo Hee Kim  ;  Joon Seok Lim  ;  Jeong-Sik Yu  ;  Jae-Joon Chung  ;  Myeong-Jin Kim  ;  Ki Whang Kim 
 RADIOGRAPHICS, Vol.30(2) : 503-516, 2010 
Journal Title
Issue Date
Chemotherapy, Adjuvant* ; Combined Modality Therapy ; Humans ; Magnetic Resonance Imaging/methods* ; Neoplasm Recurrence, Local/diagnosis* ; Neoplasm Recurrence, Local/prevention & control* ; Neoplasm Staging ; Radiotherapy, Adjuvant* ; Rectal Neoplasms/diagnosis* ; Rectal Neoplasms/therapy* ; Treatment Outcome
In patients with rectal cancer who have received concurrent chemotherapy and radiation therapy (CCRT) before surgery, magnetic resonance (MR) imaging has low accuracy in prediction of the pathologic stage owing to overstaging or understaging. The factors related to this problem include fibrosis, desmoplastic reaction, edema, inflammation, and viable tumor nets at a fibrotic scar from a previous tumor. Preoperative diagnosis with MR imaging of histologic variants of rectal adenocarcinoma, especially mucinous adenocarcinoma, is important because these variants tend to have a poor response to CCRT. In addition, these variants manifest with high signal intensity on T2-weighted images after CCRT; this finding makes it difficult to differentiate residual tumors from remaining mucin pools. MR volumetry and functional MR imaging may be helpful in prediction and assessment of tumor response to CCRT. Awareness of post-CCRT changes helps radiologists achieve appropriate restaging of irradiated rectal cancer with MR imaging and can lead to a reduction in understaging or overstaging. It is important to obtain and compare both pre- and post-CCRT images before interpreting the post-CCRT images.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Dae Jung(김대중)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
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