Congress:
ECR24
Poster Number:
C-23936
Type:
EPOS Radiologist (educational)
DOI:
10.26044/ecr2024/C-23936
Authorblock:
J. Goyal, N. Agarwal, P. Garg, S. K. Puri; NEWDELHI/IN
Disclosures:
Jitin Goyal:
Nothing to disclose
Nitin Agarwal:
Nothing to disclose
Prerna Garg:
Nothing to disclose
Sunil Kumar Puri:
Nothing to disclose
Keywords:
Gastrointestinal tract, Oncology, MR, Contrast agent-intravenous, Cancer
- Rectal adenocarcinomas constitute about one-third of all colorectal adenocarcinoma cases.
- MRI (Magnetic resonance Imaging) plays an important role in the initial staging of disease, and nodal involvement, to evaluate circumferential resection margin and extramural vascular invasion due to its superior soft tissue resolution and characterization.
- Surgery is the mainstay of treatment in localized rectal cancers; however neoadjuvant chemotherapy is indicated in advanced rectal adenocarcinoma due to better local recurrence-free survival.
- Neoadjuvant chemoradiotherapy is currently recommended for locally advanced (T3 or T4) rectal adenocarcinoma regardless of lymph node status, Early (T1 or T2) rectal adenocarcinoma with locoregional lymph node involvement, and Patients with low rectal T1 and T2 adenocarcinomas that involve the anal sphincter regardless of their nodal status.
- Pathological Complete Response - the absence of any residual tumor on the surgically resected specimen after neoadjuvant chemoradiotherapy(CRT).
- Clinical Complete Response - absent residual tumor at all three post-treatment evaluations (digital rectal examination, endoscopy, and rectal MRI) after neoadjuvant CRT.
- After completion of neoadjuvant Chemoradiotherapy, re-evaluation with contrast-enhanced MRI is usually done after 8-12 weeks.
- Response evaluation on MRI has been implemented using an mrTRG (MRI-tumor regression grade), a 5-point grading scale based on relative proportions of residual tumor and morphological changes like fibrosis and mucin production.