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CC BY 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2025; 08(02): 122-129
DOI: 10.1055/s-0045-1802320
Review Article

Pitfalls and Challenges in the Interpretation of Rectal Cancer Magnetic Resonance Imaging

Authors

  • Abdul Haseeb Wani

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Naseer A. Choh

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Humairah M. Syed

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Waris A. Mir 

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Rauf A. Wani

    2   Department of General and Minimal Invasive Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Irfan Robbani

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Tahleel A. Shera 

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

Funding None.
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Abstract

Magnetic resonance imaging (MRI) has taken a center stage in the imaging armamentarium of rectal cancer evaluation. Rectal cancer staging has undergone a paradigm shift from a surgico-pathological approach to a chemo-radiological one, helping effectively stratify patients for appropriate management. Primary lesion characterization, its morphology and internal characteristics, proximity of tumor to the mesorectal fascia, presence of extramural venous invasion, presence of extra mesorectal pelvic lymph nodes, and involvement of peritoneum and distant metastases are critical findings that impact patient management for which MRI is the preoperative gold standard. However, there are pitfalls, challenges, and misinterpretations related to technique, image quality, and knowledge gaps among the radiologists. These have major implications for patient management and their outcomes. In this article, we highlight the pitfalls and challenges in rectal cancer MRI and present practical solutions to circumvent these.

Keywords

rectal cancer staging - MRI protocol - diffusion weighted imaging - pitfalls and challenges


Publikationsverlauf

Artikel online veröffentlicht:
23. Januar 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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