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Congress: ECR25
Poster Number: C-12115
Type: Poster: EPOS Radiologist (educational)
Authorblock: D. Luengo Gómez, A. J. Lainez Ramos-Bossini, S. Molina Espinoza, Á. Salmerón Ruiz; Granada/ES
Disclosures:
David Luengo Gómez: Nothing to disclose
Antonio Jesus Lainez Ramos-Bossini: Nothing to disclose
Sergio Molina Espinoza: Nothing to disclose
Ángela Salmerón Ruiz: Nothing to disclose
Keywords: Abdomen, Oncology, MR, Observer performance, Radiation effects, Radiation therapy / Oncology, Cancer
Learning objectives To analyse the specific challenges and potential solutions in rectal cancer restaging using MRI after neoadjuvant therapy, focusing on diagnostic accuracy and treatment planning.
Read more Background In locally advanced rectal cancer (LARC), neoadjuvant chemoradiotherapy (CRT) has significantly improved oncological outcomes, with more than 30% of patients achieving a pathological complete response (pCR). Patients with an appropriately assessed complete clinical response (cCR) can often avoid radical surgery, thereby preserving quality of life without compromising survival. This shift has created an urgent need for precise characterisation of tumour regression to facilitate personalised treatment strategies.Although most studies have investigated the predictive role of MRI in LARC patients following CRT,...
Read more Findings and procedure details 1. DIFFERENTIATING BETWEEN RESIDUAL TUMOUR, FIBROSIS, AND OEDEMAAfter treatment, residual tumour, fibrosis and oedema often overlap, making differentiation difficult. Accurate pre-treatment localisation and analysis of tumour characteristics are essential to overcome this problem. Post-treatment changes may mimic residual tumour in adjacent or even contralateral areas. Evaluations should compare the current tumour bed with the original tumour location to avoid misinterpreting responses in previously unaffected areas. The addition of diffusion weighted imaging (DWI) sequences has been shown to be beneficial. The...
Read more Conclusion MRI restaging of rectal cancer after neoadjuvant therapy presents challenges, including differentiation between residual tumour, fibrosis and oedema, lymph node assessment and evaluation of key structures.An appropriate approach and the integration of advanced sequences can improve diagnostic accuracy, enable personalised treatment strategies, optimise oncological outcomes and, in some cases, avoid unnecessary surgery, thereby improving patients' quality of life.
Read more References [1] Fernandes MC, Gollub MJ, et al. The importance of MRI for rectal cancer evaluation. Surg Oncol 2022;43. doi.org/10.1016/J.SURONC.2022.101739.[2] Jayaprakasam VS, Alvarez J, et al. Watch-and-Wait Approach to Rectal Cancer: The Role of Imaging. Radiology 2023;307. doi.org/10.1148/RADIOL.221529.[3] Kuo LJ, Chern MC, et al. Interpretation of magnetic resonance imaging for locally advanced rectal carcinoma after preoperative chemoradiation therapy. Dis Colon Rectum 2005;48:23–8. doi.org/10.1007/S10350-004-0787-5.[4] Lambregts DMJ, Vandecaveye V, et al. Diffusion-Weighted MRI for Selection of Complete Responders After Chemoradiation for Locally Advanced...
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