Abdominal Imaging

, Volume 38, Issue 1, pp 72–81 | Cite as

Local colorectal cancer recurrence: pelvic MRI evaluation

  • A. ColosioEmail author
  • P. Fornès
  • P. Soyer
  • M. Lewin
  • M. Loock
  • C. Hoeffel


Surveillance of colorectal cancer is currently based on dosage of tumoral markers, colonoscopy and multidetector row computed tomography. However, pelvic magnetic resonance imaging (MRI) and PET–CT are two second-line useful imaging modalities to assess colorectal cancer local recurrence (LR). The anatomical information derived from MRI combined to the functional information provided by diffusion-weighted imaging currently remain of value. Pelvic MRI is accurate not only for detection of pelvic colorectal recurrence but also for the prediction of absence of tumoral invasion in pelvic structures, and it may thus provide a preoperative road map of the recurrence to allow for appropriate surgical planning. As always, correlation of imaging and clinical findings in the multidisciplinary forum is paramount. MRI can also be used to follow-up LR treated with radiofrequency ablation. The aim of this review is to discuss clinical practice and application of MRI in the assessment or pelvic recurrence from colorectal cancer.


Rectum Local recurrence MRI Follow-up 


  1. 1.
    Abulafi AM, William NS (1994) The local recurrence of colorectal cancer: the problem, mechanisms, management and adjuvant therapy. Br J Surg 81:7–19PubMedCrossRefGoogle Scholar
  2. 2.
    Turk PS, Wanebo HJ (1993) Results of surgical treatment of nonhepatic recurrence of colorectal carcinoma. Cancer 71:4267–4277PubMedCrossRefGoogle Scholar
  3. 3.
    Hahnloser D, Nelson H, Gunderson LL, et al. (2003) Curative potential of multimodality therapy for locally recurrent rectal cancer. Ann Surg 237:502–508PubMedGoogle Scholar
  4. 4.
    Bedrosian I, Giacco G, Pederson L, et al. (2006) Outcome after curative resection for locally recurrent rectal cancer. Dis Colon Rectum 49:175–182PubMedCrossRefGoogle Scholar
  5. 5.
    Dresen RC, Gosens MJ, Martijn H, et al. (2008) Radical resection after IORT-containing multimodality treatment is the most important determinant for outcome in patients treated for locally recurrent rectal cancer. Ann Surg Oncol 15:1937–1947PubMedCrossRefGoogle Scholar
  6. 6.
    Valentini V, Morganti AG, Gambacorta MA, et al. (2006) Preoperative hyperfractionated chemoradiation for locally recurrent rectal cancer in patients previously irradiated to the pelvis: A multicentric phase II study. Int J Radiat Oncol Biol Phys 64:1129–1139PubMedCrossRefGoogle Scholar
  7. 7.
    Boyle KM, Sagar PM, Chalmers AG, et al. (2005) Surgery for locally recurrent rectal cancer. Dis Colon Rectum 48:929–937PubMedCrossRefGoogle Scholar
  8. 8.
    Van Cutsem E, Nordlinger B, Cervantes A, et al. (2010) Advanced colorectal cancer: ESMO clinical practice guidelines for treatment. Ann Oncol 21(Suppl 5):93–97CrossRefGoogle Scholar
  9. 9.
    Enríquez-Navascués JM, Borda N, Lizerazu A, et al. (2011) Patterns of local recurrence in rectal cancer after a multidisciplinary approach. World J Gastroenterol 17:1674–1684PubMedCrossRefGoogle Scholar
  10. 10.
    Quirke P, Steele R, Monson J, et al. (2009) Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet 373:821–828PubMedCrossRefGoogle Scholar
  11. 11.
    Guillem JG, Minsky BD (2008) Extended perineal resection of distal rectal cancers: surgical advance, increased utilization of neoadjuvant therapies, proper patient selection or all of the above? J Clin Oncol 26:3481–3482PubMedCrossRefGoogle Scholar
  12. 12.
    Kusters M, Marijnen CA, van de Velde CJ, et al. (2010) Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial. Eur J Surg Oncol 36:470–476PubMedCrossRefGoogle Scholar
  13. 13.
    Titu LV, Nicholson AA, Hartley JE, Breen DJ, Monson JR (2006) Routine follow-up by magnetic resonance imaging does not improve detection of resectable local recurrences from colorectal cancer. Ann Surg 243:348–352PubMedCrossRefGoogle Scholar
  14. 14.
    Maas M, Rutten IJ, Nelemans PJ, et al. (2011) What is the most accurate whole-body imaging modality for assessment of local and distant recurrent disease in colorectal cancer? A meta-analysis: imaging for recurrent colorectal cancer. Eur J Nucl Med Mol Imaging 38:1560–1571PubMedCrossRefGoogle Scholar
  15. 15.
    Schmidt GP, Baur-Melnyk A, Haug A, et al. (2009) Whole-body MRI at 1.5 T and 3 T compared with FDG-PET-CT for the detection of tumour recurrence in patients with colorectal cancer. Eur Radiol 19:1366–1378PubMedCrossRefGoogle Scholar
  16. 16.
    Even-Sapir E, Parag Y, Lerman H, et al. (2004) Detection of recurrence in patients with rectal cancer: PET/CT after abdominoperineal or anterior resection. Radiology 232:815–822PubMedCrossRefGoogle Scholar
  17. 17.
    Von Schulthess GK, Steinert HC, Hany TF (2006) Integrated PET/CT: current applications and future directions. Radiology 238:405–422CrossRefGoogle Scholar
  18. 18.
    Moore HG, Akhurst T, Larson SM, et al. (2003) A case-controlled study of 18-fluorodeoxyglucose positron emission tomography in the detection of pelvic recurrence in previously irradiated rectal cancer patients. J Am Coll Surg 197:22–28PubMedCrossRefGoogle Scholar
  19. 19.
    Potter KC, Husband JE, Houghton SL, Thomas K, Brown G (2009) Diagnostic accuracy of serial CT/magnetic resonance imaging review vs. positron emission tomography/CT in colorectal cancer patients with suspected and known recurrence. Dis Colon Rectum 52:253–259PubMedCrossRefGoogle Scholar
  20. 20.
    Markus J, Morrissey B, deGara C, Tarulli G (1997) MRI of recurrent rectosigmoid carcinoma. Abdom Imaging 22:338–342PubMedCrossRefGoogle Scholar
  21. 21.
    Messiou C, Chalmers A, Boyle K, Sagar P (2006) Surgery for recurrent rectal carcinoma: the role of preoperative magnetic resonance imaging. Clin Radiol 61:250–258PubMedCrossRefGoogle Scholar
  22. 22.
    Tan PL, Chan CL, Moore NR (2005) Radiological appearances in the pelvis following rectal cancer surgery. Clin Radiol 60:846–855PubMedCrossRefGoogle Scholar
  23. 23.
    Robinson P, Carrington BM, Swindell R, Shanks JH, O’dwyer ST (2002) Recurrent or residual pelvic bowel cancer: accuracy of MRI local extent before salvage surgery. Clin Radiol 57:514–522PubMedCrossRefGoogle Scholar
  24. 24.
    Brown G, Drury AE, Cunningham D, Husband JE (2003) CT detection of hydronephrosis in resected colorectal cancer: a predictor of recurrent disease. Clin Radiol 58:137–142PubMedCrossRefGoogle Scholar
  25. 25.
    Lambregts DM, Cappendijk VC, Maas M, Beets GL, Beets-Tan RG (2011) Value of MRI and diffusion-weighted MRI for the diagnosis of locally recurrent rectal cancer. Eur Radiol 21:1250–1258PubMedCrossRefGoogle Scholar
  26. 26.
    Kim DJ, Kim JH, Lim JS, et al. (2010) Restaging of rectal cancer with MR imaging after concurrent chemotherapy and radiation therapy. Radiographics 30:503–516PubMedCrossRefGoogle Scholar
  27. 27.
    Kim SH, Lee JM, Hong SH, et al. (2009) Locally advanced rectal cancer: added value of diffusion-weighted MR imaging in the evaluation of tumor response to neoadjuvant chemo- and radiation therapy. Radiology 253:116–125PubMedCrossRefGoogle Scholar
  28. 28.
    Barbaro B, Vitale R, Leccisotti L, et al. (2010) Restaging locally advanced rectal cancer with MR imaging after chemoradiation therapy. Radiographics 30:699–716PubMedCrossRefGoogle Scholar
  29. 29.
    Sagar PM, Pemberton JH (1996) Surgical management of locally recurrent rectal cancer. Br J Surg 83:293–304PubMedCrossRefGoogle Scholar
  30. 30.
    Lopez-Kostner F, Fazio VW, Vignali A, Rybicki LA, Lavery IC (2001) Locally recurrent rectal cancer: predictors and success of salvage surgery. Dis Colon Rectum 44:173–178PubMedCrossRefGoogle Scholar
  31. 31.
    Belfiore G, Tedeschi E, Ronza FM, et al. (2009) CT-guided radiofrequency ablation in the treatment of recurrent rectal cancer. Am J Roentgenol 192:137–141CrossRefGoogle Scholar
  32. 32.
    Green SH, Khatri VP, McGahan JP (2008) Radiofrequency ablation as salvage therapy for unresectable locally recurrent rectal cancer. J Vasc Interv Radiol 19:454–458PubMedCrossRefGoogle Scholar
  33. 33.
    Lefevre JH, Parc Y, Lewin M, et al. (2008) Radiofrequency ablation for recurrent pelvic cancer. Colorectal Dis 10:781–784PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • A. Colosio
    • 1
    Email author
  • P. Fornès
    • 2
  • P. Soyer
    • 3
  • M. Lewin
    • 4
  • M. Loock
    • 1
  • C. Hoeffel
    • 1
  1. 1.Pôle d’imagerie, Department of RadiologyHôpital Robert Debré, CHU de ReimsReims CedexFrance
  2. 2.Department of PathologyHôpital Robert Debré, CHU ReimsReimsFrance
  3. 3.Department of Abdominal ImagingHôpital Lariboisière Assistance Publique-Hôpitaux de ParisParisFrance
  4. 4.Department of RadiologyHôpital Paul-Brousse Groupe Hospitalier, Hôpitaux Universitaires Paris SudVillejuifFrance

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