MRI in rectal cancer: the T stage and circumferential resection margin

Different stages of rectal cancer show differing degrees of risk for local recurrence. Paramount for the selection and differentiated treatment of the different risk groups is a reliable preoperative test that can distinguish between these subgroups. There is recent evidence suggesting that MRI can serve for this purpose, because it accurately predicts the circumferential resection margin. In this article the role of MRI in the preoperative management of rectal cancer patients will be discussed.

Rectal cancer: how accurate can imaging predict the T stage and the circumferential resection margin?

BACKGROUND

One of the concerns after rectal cancer surgery is the local recurrence rate. Randomized trials have shown that the best local control rate for rectal cancer patients overall is obtained by a short preoperative course of radiotherapy followed by a total mesorectal excision, but there are however subgroups of rectal cancer patients with varying risks of recurrences.

DISCUSSION

At one end of the continuum are patients with stage I disease who are at very low risk of local recurrence. At the other end are the patients with locally advanced tumor who are at very high risk, and who would benefit from a more extensive neoadjuvant treatment schedule. This kind of differentiated treatment can be performed only when there is an accurate tool to identify preoperatively the different risk groups. There is recent evidence, suggesting that MRI can serve for this purpose, because it accurately predicts the tumor free circumferential resection margin at TME.

CONCLUSION

This article provides a literature review of the value of preoperative imaging in rectal cancer surgery.

High resolution MRI of anorectal malformation in the newborn: case reports of Currarino syndrome and anocutaneous fistula

To show the accuracy of a high-resolution magnetic resonance imaging (MRI) technique with a phased array coil in diagnosing anorectal malformation, we present two neonates with Currarino syndrome and anocutaneous fistula, respectively. Anatomy was visualized correctly with this technique, but conventional MRI did not show the complete extent of the disease. The reported high-resolution MRI findings concerning these conditions are scanty.