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Subject Area

Radiology

Article Type

Original Study

Abstract

Objectives:

To evaluate the accuracy of Magnetic Resonance Imaging [MRI] in local staging of rectal cancer and effect on management and outcome.

Background:

MRI is currently considered the best modality for primary staging of rectal cancer, post chemoradiotherapy, follow up, tailoring surgery and follow-up.

Methods:

This was a retrospective study that included 130 cases diagnosed with rectal cancer. All patients had an MRI with a dedicated protocol for local staging. Multidisciplinary meetings [MDM] were held regularly for decision making along the journey of the tumour management. Regular post-operative surveillance was performed to rule out recurrence. Analysis of the outcome was done for each case after 3 years from first MDM.

Results:

Comparing the result of surgical specimen with the preoperative MRI revealed good results regarding tumour [T] staging. The total accuracy was 93.4% for T stage. To some extent MRI showed lower accuracy for lymph node evaluation that was 69.7%. After 3 years follow-up, the recurrence rate of tumour was only about 5% for the surgical approach which was the decision 105 cases. Non-surgical approach exhibited promising outcome and it was a choice for 25 cases. MRI was the corner stone at each MDM discussion and in decision making.

Conclusion:

MRI can be considered a reliable modality for primary staging of rectal cancer cases, follow-up after CRT, operative planning and post-operative follow-up. Depending upon MRI in decision making helps in decreasing recurrence rate of rectal cancer even with less aggressive operations and non-operative management.

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