Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting

  • Regina G. H. Beets-Tan
  • Doenja M. J. Lambregts
  • Monique Maas
  • Shandra Bipat
  • Brunella Barbaro
  • Luís Curvo-Semedo
  • Helen M. Fenlon
  • Marc J. Gollub
  • Sofia Gourtsoyianni
  • Steve Halligan
  • Christine Hoeffel
  • Seung Ho Kim
  • Andrea Laghi
  • Andrea Maier
  • Søren R. Rafaelsen
  • Jaap Stoker
  • Stuart A. Taylor
  • Michael R. Torkzad
  • Lennart Blomqvist



To update the 2012 ESGAR consensus guidelines on the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer.


Fourteen abdominal imaging experts from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) participated in a consensus meeting, organised according to an adaptation of the RAND-UCLA Appropriateness Method. Two independent (non-voting) Chairs facilitated the meeting. 246 items were scored (comprising 229 items from the previous 2012 consensus and 17 additional items) and classified as ‘appropriate’ or ‘inappropriate’ (defined by ≥ 80 % consensus) or uncertain (defined by < 80 % consensus).


Consensus was reached for 226 (92 %) of items. From these recommendations regarding hardware, patient preparation, imaging sequences and acquisition, criteria for MR imaging evaluation and reporting structure were constructed. The main additions to the 2012 consensus include recommendations regarding use of diffusion-weighted imaging, criteria for nodal staging and a recommended structured report template.


These updated expert consensus recommendations should be used as clinical guidelines for primary staging and restaging of rectal cancer using MRI.

Key Points

These guidelines present recommendations for staging and reporting of rectal cancer.

The guidelines were constructed through consensus amongst 14 pelvic imaging experts.

Consensus was reached by the experts for 92 % of the 246 items discussed.

Practical guidelines for nodal staging are proposed.

A structured reporting template is presented.


Magnetic resonance imaging Cancer rectal neoplasms Standards Staging Structured reporting 

Supplementary material

330_2017_5026_MOESM1_ESM.xls (74 kb)
ESM 1(XLS 74 kb)


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Regina G. H. Beets-Tan
    • 1
  • Doenja M. J. Lambregts
    • 1
  • Monique Maas
    • 1
  • Shandra Bipat
    • 2
  • Brunella Barbaro
    • 3
  • Luís Curvo-Semedo
    • 4
  • Helen M. Fenlon
    • 5
  • Marc J. Gollub
    • 6
  • Sofia Gourtsoyianni
    • 7
  • Steve Halligan
    • 8
  • Christine Hoeffel
    • 9
  • Seung Ho Kim
    • 10
  • Andrea Laghi
    • 11
  • Andrea Maier
    • 12
  • Søren R. Rafaelsen
    • 13
  • Jaap Stoker
    • 2
  • Stuart A. Taylor
    • 8
  • Michael R. Torkzad
    • 8
  • Lennart Blomqvist
    • 14
  1. 1.Department of RadiologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  2. 2.Academic Medical CentreAmsterdamThe Netherlands
  3. 3.Catholic University School of MedicineRomeItaly
  4. 4.Coimbra University HospitalsCoimbraPortugal
  5. 5.Mater Misericordiae University HospitalDublinIreland
  6. 6.Memorial Sloan-Kettering Cancer CenterNew YorkUSA
  7. 7.Guy’s & St Thomas’ NHS FTLondonUK
  8. 8.Centre for Medical ImagingUniversity College LondonLondonUK
  9. 9.Reims University HospitalReimsFrance
  10. 10.Inje University Haeundae Paik HospitalBusanSouth Korea
  11. 11.Sapienza - University of RomeRomeItaly
  12. 12.Medical University of ViennaViennaAustria
  13. 13.Clinical Cancer CentreVejle HospitalVejleDenmark
  14. 14.Karolinska University Hospital and Karolinska InstitutetStockholmSweden

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