MRI for Rectal Cancer: Staging, mrCRM, EMVI, Lymph Node Staging and Post-Treatment Response

Clin Colorectal Cancer. 2022 Mar;21(1):10-18. doi: 10.1016/j.clcc.2021.10.007. Epub 2021 Nov 14.

Abstract

Rectal cancer is a relatively common malignancy in the United States. Magnetic resonance imaging (MRI) of rectal cancer has evolved tremendously in recent years, and has become a key component of baseline staging and treatment planning. In addition to assessing the primary tumor and locoregional lymph nodes, rectal MRI can be used to help with risk stratification by identifying high-risk features such as extramural vascular invasion and can assess treatment response for patients receiving neoadjuvant therapy. As the practice of rectal MRI continues to expand further into academic centers and private practices, standard MRI protocols, and reporting are critical. In addition, it is imperative that the radiologists reading these cases work closely with surgeons, medical oncologists, radiation oncologists, and pathologists to ensure we are providing the best possible care to patients. This review aims to provide a broad overview of the role of MRI for rectal cancer.

Keywords: Cancer staging; MRI; Radiology; Rectal cancer.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Magnetic Resonance Imaging / methods
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Rectal Neoplasms* / diagnostic imaging
  • Rectal Neoplasms* / pathology
  • Rectal Neoplasms* / therapy
  • Retrospective Studies