Importance and Qualitative Requirements of Magnetic Resonance Imaging for Therapy Planning in Rectal Cancer – Interdisciplinary Recommendations of AIO, ARO, ACO and the German Radiological Society

Author:

Attenberger Ulrike Irmgard1,Clasen Stephan2,Ghadimi Michael3,Grosse Ulrich4,Antoch Gerald5,Schreyer Andreas G.6,Wessling Johannes7,Hausmann Daniel8,Piso Pompiliu9,Plodeck Verena10,Stintzing Sebastian11,Rödel Claus Michael12,Hofheinz Ralf Dieter13

Affiliation:

1. Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Germany

2. Department of Radiology, Hospital Reutlingen, Reutlingen, Germany

3. Clinic for Surgery, University Hospital Göttingen, Göttingen, Germany

4. Department of Radiology, Cantonal Hospital Münsterlingen, Münsterlingen, Switzerland

5. President, German Radiological Society, Berlin, Germany

6. Institute for Diagnostic and Interventional Radiology, Brandenburg Medical School Theodor Fontane, Brandenburg a. d. Havel, Germany

7. Department of Diagnostic and Interventional Radiology and Neuroradiology, Clemenshospital GmbH Münster, Germany

8. Department of Radiology, Baden Cantonal Hospital, Baden, Switzerland

9. Clinic for General and Visceral Surgery, Barmherzige Brüder Hospital Regensburg, Germany

10. Institute and Polyclinic for Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus, Dresden, Germany

11. Division of Hematology, Oncology and Tumor Immunology, Charité, Medical Department, Berlin, Germany

12. Department of Radiotherapy and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany

13. III Medical Clinic, Day Therapy Centre, Medical Faculty of the University of Heidelberg, Mannheim, Germany

Abstract

Due to its excellent intrinsic soft tissue contrast, magnetic resonance imaging allows excellent visualization and anatomical separation of therapy-relevant risk structures such as the mesorectal fascia, local lymph nodes, and vascular structures in patients with rectal carcinoma. This makes magnetic resonance imaging (MRI) a valuable evaluation method for further therapeutic stratification. In particular, MRI is indispensable for the decision to refrain from neoadjuvant therapy and to choose a primary surgical approach. In addition to the oncologically generally relevant T-, N-, and M-criteria, two further parameters are included: the extramural vascular infiltration and the circumferential resection margin. Due to the significant impact of MRI on further therapeutic decision-making, standardized MR image quality is considered essential. Key Points:  Citation Format

Publisher

Georg Thieme Verlag KG

Subject

Radiology, Nuclear Medicine and imaging

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