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

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: 

• Magnetic resonance imaging is a valuable evaluation method for further therapeutic stratification.

• Critical anatomic landmarks for evaluation are circumferential resection margins.

Citation Format

• Attenberger UI, Clasen S, Ghadimi M et al. 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. Fortschr Röntgenstr 2021; 193: 513 – 520

Key words

MRI - CRM - therapeutic stratification - rectal cancer

Publication History

Received: 25 May 2020

Accepted: 24 September 2020

Article published online:
16 December 2020

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