Abstract
International guidelines dictate that magnetic resonance imaging (MRI) should be part of the primary standard work up of patients with rectal cancer because MRI can accurately identify the main risk factors for local recurrence and stratify patients into a differentiated treatment. The role of endoscopic ultrasound (EUS) is restricted to staging of superficial tumors because EUS is able to differentiate between T1 and T2 rectal cancer. Recent guidelines recommend the addition of diffusion-weighted (DWI) MRI to clinical and endoscopic assessment of response to preoperative radiochemotherapy (RCT). MRI is able to identify significant tumor regression which may alter the surgical approach.
Highlights
International guidelines dictate that magnetic resonance imaging (MRI) should be part of the primary standard work up of patients with rectal cancer because MRI can accurately identify the main risk factors for local recurrence and stratify patients into a differentiated treatment
The role of endoscopic ultrasound (EUS) is restricted to staging of superficial tumors because EUS is able to differentiate between T1 and T2 rectal cancer
Schlüsselwörter Kolorektales Karzinom · TumorStaging · Magnetresonanztomographie · Endorektale Sonographie · Endoskopischer Ultraschall texture, and round shape is highly predictive of a positive N status
Summary
The problem after rectal cancer surgery has long been the high rate of local recurrence—up to 32%—due to incomplete resection of microscopic lateral spread of the tumor [1]. On the other side of the spectrum are patients at high risk for local recurrence These patients have advanced tumors with either close relation to or involvement of the mesorectal fascia (MRF)—the circumferential resection margin of total mesorectal excision (TME)—or even extension into the surrounding organs. The value of endorectal ultrasound (EUS) and MRI in rectal cancer staging and restaging will be discussed. On restaging MRI with diffusion-weighted imaging, no restricted diffusion was visible (e) published between 1985 and 2002, were included The pooled sensitivity of EUS was 94% for the identification of T1–2, 90% for T3, and 70% for T4 stage tumors. The presence of lymph nodes 5–9 mm in size with at least two of the criteria of irregular border, heterogeneous
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