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MRI Evaluation of the Response of Rectal Cancer to Neoadjuvant Chemoradiation Therapy.

Publication ,  Journal Article
Kalisz, KR; Enzerra, MD; Paspulati, RM
Published in: Radiographics
2019

MRI plays a critical role in the staging and restaging of rectal cancer. Although newly diagnosed early-stage rectal cancers may immediately be amenable to surgical resection, patients with advanced disease first undergo neoadjuvant therapy that consists of a combination of chemotherapy and radiation therapy. Evaluation of rectal cancer after neoadjuvant therapy is best performed with MRI, given its superior soft-tissue contrast and its ability to allow multiplanar imaging and functional evaluation. In this setting, MRI allows accurate evaluation of primary tumor staging, which is determined on the basis of the depth of invasion within and through the rectal wall and the involvement of adjacent organs. MRI can also be used to evaluate posttreatment morphologic components within the tumors, including fibrosis and mucinous changes that have been shown to correlate with the response to treatment. Additional features such as the circumferential resection margin and extramural vascular invasion-factors shown to affect prognosis and local recurrence-are also assessed before and after therapy. Functional assessment with diffusion-weighted MRI and perfusion MRI plays a role in predicting tumor aggressiveness and the likelihood of response to treatment, as well as the extent of residual tumor after therapy. Lymph node staging is also performed at MRI, with assessment of not only lymph node size but also the internal architecture and signal intensity characteristics. ©RSNA, 2019 See discussion on this article by Wasnik and Al-Hawary .

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Published In

Radiographics

DOI

EISSN

1527-1323

Publication Date

2019

Volume

39

Issue

2

Start / End Page

538 / 556

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Rectum
  • Rectal Neoplasms
  • Positron-Emission Tomography
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Magnetic Resonance Imaging
  • Humans
  • Chemoradiotherapy
 

Citation

APA
Chicago
ICMJE
MLA
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Kalisz, K. R., Enzerra, M. D., & Paspulati, R. M. (2019). MRI Evaluation of the Response of Rectal Cancer to Neoadjuvant Chemoradiation Therapy. Radiographics, 39(2), 538–556. https://doi.org/10.1148/rg.2019180075
Kalisz, Kevin R., Michael D. Enzerra, and Raj M. Paspulati. “MRI Evaluation of the Response of Rectal Cancer to Neoadjuvant Chemoradiation Therapy.Radiographics 39, no. 2 (2019): 538–56. https://doi.org/10.1148/rg.2019180075.
Kalisz KR, Enzerra MD, Paspulati RM. MRI Evaluation of the Response of Rectal Cancer to Neoadjuvant Chemoradiation Therapy. Radiographics. 2019;39(2):538–56.
Kalisz, Kevin R., et al. “MRI Evaluation of the Response of Rectal Cancer to Neoadjuvant Chemoradiation Therapy.Radiographics, vol. 39, no. 2, 2019, pp. 538–56. Pubmed, doi:10.1148/rg.2019180075.
Kalisz KR, Enzerra MD, Paspulati RM. MRI Evaluation of the Response of Rectal Cancer to Neoadjuvant Chemoradiation Therapy. Radiographics. 2019;39(2):538–556.

Published In

Radiographics

DOI

EISSN

1527-1323

Publication Date

2019

Volume

39

Issue

2

Start / End Page

538 / 556

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Rectum
  • Rectal Neoplasms
  • Positron-Emission Tomography
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Magnetic Resonance Imaging
  • Humans
  • Chemoradiotherapy