MRI for Response Evaluation after Chemoradiotherapy for Locally Advanced Rectal Cancer | ||
| SECI Oncology Journal | ||
| Volume 12, Issue 1, January 2024, Pages 47-56 | ||
| Abstract | ||
| Background: Standard treatment for T3 or T4 and/or node-positive rectal cancer is preoperative chemoradiotherapy (CRT) followed by total mesorectal resection (TME). After surgery, 10–24% of patients have no remaining tumor. Complete pathologic response (pCR) after CRT has led to nonoperative treatment for carefully chosen patients with a complete clinical response (CR). 5-year overall survival (OS) and disease free survival (DFS) were 93% and 85%. DWI can evaluate chemoradiotherapy response (8-10), adding DWI to regular MRI increased radiologists' ability to select full responders. Aim: The purpose of our study is to evaluate the accuracy of MRI for selection of complete responders after chemoradiotherapy for locally advanced rectal cancer. Subject and Methods: This is a retrospective study. Baseline, post treatment MRI scans, Clinical assessment including digital rectal examination, and endoscopy are needed for each patient. Results: ADC after chemoradiotherapy in the study population ranged from 0.43 to 1.53. T2WI volumetry after CRT in the study population ranged from 3.1 to 8.7. Number of patients with good MRI - TRG in the study population was 20 (67%). Conclusion: Pathological and MRI evaluation agree well. DWI patterns and T2W MRI-based MR-TRG improve MRI's diagnostic effectiveness for predicting pathological response. Improves interobserver agreement and radiologist trust. Further studies are needed to investigate MRI-capacity TRG's to identify pathological complete responders for nonoperative therapy and to give complementary prognostic information to pathological TRG for risk- stratification following surgery. | ||
| Keywords | ||
| MRI; Rectal Cancer; Chemoradiotherapy | ||
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