Skip to main content

Introduction: Preoperative Staging by Imaging

  • Chapter
  • First Online:
Multidisciplinary Treatment of Colorectal Cancer
  • 863 Accesses

Abstract

In recent decades, the role of imaging in the local staging of rectal cancer has evolved. Whereas in the past, its role has been restricted mainly to endorectal ultrasound, it has recently extended to modern imaging such as CT and MRI. This chapter on “imaging and staging” will address the two most frequently used imaging methods in rectal cancer management: endorectal ultrasound (EUS) and magnetic resonance imaging (MRI). For each, experts in the field will elaborate on how these methods can identify the relevant risk factors for local recurrence and which protocol should be used to ensure a high-quality performance. In this section, the introduction, a helicopter view is given on the role of each method, EUS and MRI, in the context of clinical decision-making and its role put in perspective of one another. The introduction finalizes with recommendations for use in clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gunderson LL, Sargent DJ, Tepper JE, et al. Impact of T and N substage on survival and disease relapse in adjuvant rectal cancer: a pooled analysis. Int J Radiat Oncol Biol Phys. 2002;54(2):386–96.

    Article  Google Scholar 

  2. Nagtegaal ID, Quirke P. What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol. 2008;26(2):303–12.

    Article  Google Scholar 

  3. NIH Consensus Conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA. 1990;264(11):1444–50.

    Article  Google Scholar 

  4. Marijnen CA, Nagtegaal ID, Kapiteijn E, et al. Radiotherapy does not compensate for positive resection margins in rectal cancer patients: report of a multicenter randomized trial. Int J Radiat Oncol Biol Phys. 2003;55(5):1311–20.

    Article  CAS  Google Scholar 

  5. Edelman BR, Weiser MR. Endorectal ultrasound: its role in the diagnosis and treatment of rectal cancer. Clin Colon Rectal Surg. 2008;21(3):167–77.

    Article  Google Scholar 

  6. Schaffzin DM, Wong WD. Endorectal ultrasound in the preoperative evaluation of rectal cancer. Clin Colorectal Cancer. 2004;4(2):124–32.

    Article  Google Scholar 

  7. Harewood GC. Assessment of publication bias in the reporting of EUS performance in staging rectal cancer. Am J Gastroenterol. 2005;100(4):808–16.

    Article  Google Scholar 

  8. Bipat S, Glas AS, Slors FJ, Zwinderman AH, Bossuyt PM, Stoker J. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging—a meta-analysis. Radiology. 2004;232(3):773–83.

    Article  Google Scholar 

  9. Peeters KC, Marijnen CA, Nagtegaal ID, et al. The TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma. Ann Surg. 2007;246(5):693–701.

    Article  Google Scholar 

  10. Beets-Tan RG, Beets GL, Vliegen RF, et al. Accuracy of magnetic resonance imaging in prediction of tumour-free resection margin in rectal cancer surgery. Lancet. 2001;357(9255):497–504.

    Article  CAS  Google Scholar 

  11. MERCURY Study Group. Extramural depth of tumor invasion at thin-section MR in patients with rectal cancer: results of the MERCURY study. Radiology. 2007;243(1):132–9.

    Article  Google Scholar 

  12. Bissett IP, Fernando CC, Hough DM, et al. Identification of the fascia propria by magnetic resonance imaging and its relevance to preoperative assessment of rectal cancer. Dis Colon Rectum. 2001;44(2):259–65.

    Article  CAS  Google Scholar 

  13. Blomqvist L, Machado M, Rubio C, et al. Rectal tumour staging: MR imaging using pelvic phased-array and endorectal coils vs endoscopic ultrasonography. Eur Radiol. 2000;10(4):653–60.

    Article  CAS  Google Scholar 

  14. Lahaye MJ, Engelen SM, Nelemans PJ, et al. Imaging for predicting the risk factors—the circumferential resection margin and nodal disease—of local recurrence in rectal cancer: a meta-analysis. Semin Ultrasound CT MR. 2005;26(4):259–68.

    Article  CAS  Google Scholar 

  15. Wang C, Zhou Z, Wang Z, et al. Patterns of neoplastic foci and lymph node micrometastasis within the mesorectum. Langenbecks Arch Surg. 2005;390(4):312–8.

    Article  Google Scholar 

  16. Guillem JG, Diaz-Gonzalez JA, Minsky BD, et al. cT3N0 rectal cancer: potential overtreatment with preoperative chemoradiotherapy is warranted. J Clin Oncol. 2008;26(3):368–73.

    Article  Google Scholar 

  17. Sebag-Montefiore D, Stephens RJ, Steele R, et al. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet. 2009;373(9666):811–20.

    Article  Google Scholar 

  18. van der Valk MJM, Hilling DE, Bastiaannet E, et al. IWWD Consortium. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study. Lancet. 2018;391(10139):2537–45.

    Article  Google Scholar 

  19. Lambregts DM, Rao SX, Sassen S, et al. MRI and diffusion-weighted MRI volumetry for identification of complete tumor responders after preoperative chemoradiotherapy in patients with rectal cancer: a bi-institutional validation study. Ann Surg. 2015;262(6):1034–9.

    Article  Google Scholar 

  20. Maas M, Lambregts DM, Nelemans PJ, Heijnen LA, et al. Assessment of clinical complete response after chemoradiation for rectal cancer with digital rectal examination, endoscopy, and MRI: selection for organ-saving treatment. Ann Surg Oncol. 2015;22(12):3873–80.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Regina G. H. Beets-Tan .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Beets-Tan, R.G.H. (2021). Introduction: Preoperative Staging by Imaging. In: Baatrup, G. (eds) Multidisciplinary Treatment of Colorectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-58846-5_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-58846-5_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-58845-8

  • Online ISBN: 978-3-030-58846-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics