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Congress: ECR26
Poster Number: C-14935
Type: Poster: EPOS Radiologist (educational)
Authorblock: L. Martínez de Vega, R. Garcia Latorre, A. Fernández Rodríguez, A. M. Vera Carmona, N. Bravo Alcobendas, A. Salgado-Parente, E. Canales Lachén; Madrid/ES
Disclosures:
Lucía Martínez de Vega: Nothing to disclose
Raquel Garcia Latorre: Nothing to disclose
Alba Fernández Rodríguez: Nothing to disclose
Ana María Vera Carmona: Nothing to disclose
Noelia Bravo Alcobendas: Nothing to disclose
Alba Salgado-Parente: Nothing to disclose
Elena Canales Lachén: Nothing to disclose
Keywords: Abdomen, MR, Chemotherapy, Education, Radiation therapy / Oncology, Cancer
Learning objectives Review of anorectal anatomy in MRI and semiology of rectal adenocarcinoma. Review the TNM staging and the different treatment options in rectal cancer.  Review of the study acquisition protocol: oblique sequences to the tumor. Review of MR findings after radio-chemotherapy treatment by using illustrative cases, the degree of response and the main pitfalls.
Read more Background Colorectal cancer represents the second most frequent tumor diagnosed in the population after breast and prostate. Given its high prevalence and the fact that its incidence is increasing in young patients, an "organ-preserving" therapeutic management is currently preferred after achieving a complete tumor response with effective neoadjuvant chemoradiotherapy; thus, avoiding the harmful effects and morbidity of surgery. This strategy is known as "Watch & Wait" and consists of a close follow-up where MRI plays a leading role.
Read more Findings and procedure details 1. Rectal Anatomy on MRIThe rectum is divided according to its distance from the anorectal junction into low (0–5 cm), mid (5–10 cm), and high (10–15 cm).MRI depicts the rectal wall layers, the surrounding tissues and the sphincter complex, all of which are critical landmarks for staging and surgical planning. [fig 1] [fig 2] 2. MRI Tumor StagingT StageDifferences in T2w signal intensity of the rectal wall layers allow accurate assessment of mural invasion and regional spread. The mucosa and muscularis propia appears hypointense while...
Read more Conclusion Re-staging of rectal adenocarcinoma using MRI has become fundamental, especially for the selection and follow-up of those patients with a complete response after neoadjuvant therapy who are candidates for non-surgical therapeutic management that avoids the morbidity of amputation or resection.
Read more References Kalisz KR, Enzerra MD, Paspulati RM. MRI Evaluation of the Response of Rectal Cancer to Neoadjuvant Chemoradiation Therapy. Radiographics. 2019 Mar-Apr;39(2):538-556.doi: 10.1148/rg.2019180075. Santiago I, Rodrigues B, Barata M, Figueiredo N, Fernandez L, Galzerano A, Parés O, Matos C. Re-staging and follow-up of rectal cancer patients with MR imaging when "Watch-and-Wait" is an option: a practical guide. Insights Imaging. 2021 Aug 9;12(1):114. doi: 10.1186/s13244-021-01055-w. Awiwi MO, Kaur H, Ernst R, Rauch GM, Morani AC, Stanietzky N, Palmquist SM, Salem UI. Restaging MRI of...
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