Skip to main content

Rectum

  • Chapter
  • First Online:
Clinical MRI of the Abdomen

Abstract

Main indication of magnetic resonance imaging (MRI) of the rectum is local staging of primary rectal cancer. Introduction of new generation MRI scanners with optimal phased array body coils, resulting in improved contrast and spatial resolution images due to better signal-to-noise ratio, has contributed to the production of high-resolution images in which visualization of anatomical details, such as the mesorectal fascia and the bowel wall layers, is feasible. As a consequence, we have reached the point where the shift in diagnostic paradigms is the recommendation of rectal MRI as a part of the standard work up in the preoperative staging of rectal cancer patients.

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 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
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. GLOBOCAN (2002) Cancer incidence, mortality and prevalence worldwide. International Agency for Research on Cancer European Network of Cancer Registries. www-dep.iarc.fr. Accessed 19 Oct 2008

  2. Cancer Research UK http://info.cancerresearchuk.org/cancerstats. Accessed 19 Oct 2008

  3. Kang H, óConnell JB, Leonardi MJ, Maggard MA, McGory ML, Ko CY (2007 Feb) Rare tumors of the colon and rectum: a national review. Int J Colorectal Dis 22(2):183–189

    Article  PubMed  Google Scholar 

  4. Pahlman L (2000) Neoadjuvant and adjuvant radio- and radio-chemotherapy of rectal carcinomas. Int J Colorectal Dis 15:1–8, review

    Article  PubMed  CAS  Google Scholar 

  5. Wibe A, Rendedal P, Svensson E et al (2002) Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancer. Br J Surg 89:327–334

    Article  CAS  Google Scholar 

  6. Quirke P, Durdey P, Dixon MF et al (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection: histopathological study of lateral tumor spread and surgical excision. Lancet 2:996–999

    Article  PubMed  CAS  Google Scholar 

  7. Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1:1479–1482

    Article  PubMed  CAS  Google Scholar 

  8. Folkesson J, Birgisson H, Pahlman L, Cedermark B, Glimelius B, Gunnarsson U (2005 Aug 20) Swedish Rectal Cancer Trial: long lasting benefits from radiotherapy on survival and local recurrence rate. J Clin Oncol 23(24):5644–5650

    Article  PubMed  Google Scholar 

  9. Kapiteijn E, Marijnen C, Nagtegaal I et al (2001) Preoperative radiotherapy combined with totalmesorectal excision for resectable rectal cancer. N Engl J Med 345:638–646

    Article  PubMed  CAS  Google Scholar 

  10. Sauer R, Becker H, Hohenberger W et al (2004 Oct 21) German Rectal Cancer Study Group Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351(17):1731–1740

    Article  PubMed  CAS  Google Scholar 

  11. Beets-Tan RG, Beets GL (2004) Rectal cancer: review with emphasis on MR imaging. Radiology 232(2):335–346

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  13. MERCURY Study Group (2006) Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observation study. BMJ 333:779

    Article  Google Scholar 

  14. Engelen SM, Beets-Tan RG, Lahaye MJ, Kessels AG, Beets GL (2008 July) Location of involved mesorectal and extramesorectal lymph nodes in patients with primary rectal cancer: preoperative assessment with MR imaging. Eur J Surg Oncol 34(7):776–781

    Article  PubMed  CAS  Google Scholar 

  15. Brown G (2008 Oct 4) Staging rectal cancer: endoscopic ultrasound and pelvic MRI. Cancer Imaging 8(Suppl A):S43–S45

    Article  PubMed  Google Scholar 

  16. Vogl T, Pegios W, Mack M et al (1997) Accuracy of staging rectal tumors with contrast-enhanced transrectal MR Imaging. AJR Am J Roentgenol 168:1427–1434

    PubMed  CAS  Google Scholar 

  17. Bipat S, Glas AS, Slors FJ, Zwinderman AH, Bossuyt PM, Stoker J (2004) Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging – a meta-analysis. Radiology 232(3):773–783

    Article  PubMed  Google Scholar 

  18. Vliegen RF, Beets GL, von Meyenfeldt MF et al (2005 Jan) Rectal cancer: MR imaging in local staging – is gadolinium-based contrast material helpful? Radiology 234(1):179–188

    Article  PubMed  Google Scholar 

  19. Will O, Purkayasthas S, Chan C et al (2005) Diagnostic precision of nanoparticle – enhanced MRI for lymph-node metastases: a meta analysis. Lancet Oncol 7:52–60

    Article  Google Scholar 

  20. Brown G, Richards CJ, Bourne MW et al (2003) Morphologic predictors of lymph node status in rectal cancer with use of high spatial resolution MR imaging with histopathologic comparison. Radiology 227(2):371–377

    Article  PubMed  Google Scholar 

  21. Kim JH, Beets GL, Kim MJ, Kessels AG, Beets-Tan RG (2004) High resolution MR imaging for nodal staging in rectal cancer: are there any criteria in addition to the size? Eur J Radiol 52(1):78–83

    Article  PubMed  Google Scholar 

  22. Marusch F, Koch A, Schmidt U et al (2002) Routine use of transrectal ultrasound in rectal carcinoma: results of a prospective multicenter study. Endoscopy 34(5):385–390

    Article  PubMed  CAS  Google Scholar 

  23. Beets-Tan RG, Beets GL, Borstlap AC et al (2000 Sept–Oct) Preoperative assessment of local tumor extent in advanced rectal cancer: CT or high-resolution MRI? Abdom Imaging 25(5):533–541

    Article  PubMed  CAS  Google Scholar 

  24. Blomqvist L, Holm T, Nyrén S, Svanström R, Ulvskog Y, Iselius L (2002 Mar) MR imaging and computed tomography in patients with rectal tumours clinically judged as locally advanced. Clin Radiol 57(3):211–218

    Article  PubMed  Google Scholar 

  25. Wolberink SV, Beets-Tan RG, de Haas-Kock DF et al (2007) Conventional CT for the prediction of an involved circumferential resection margin in primary rectal cancer. Dig Dis 25(1):80–85

    Article  PubMed  Google Scholar 

  26. Wolberink SV, Beets-Tan RG, de Haas-Kock DF, van de Jagt E, Span M, Wiggers T (2009) Multislice CT as a primary screening tool for the prediction of an involved mesorectal fascia and distant metastases in primary rectal cancer: a multicenter study. Dis Colon Rectum 52(5):928–934

    Google Scholar 

  27. Vliegen R, Dresen R, Beets G et al (2008 Sep-Oct) The accuracy of Multi-detector row CT for the assessment of tumor invasion of the mesorectal fascia in primary rectal cancer. Abdom Imaging 33(5):604–610

    Article  PubMed  Google Scholar 

  28. Lezoche E, Guerrieri M, Paganini AM, Baldarelli M, De Sanctis A, Lezoche G (2005) Long term results in patients with T2-3 N0 distal rectal cancer undergoing radiotherapy before transanal endoscopic microsurgery. Br J Surg 92(12):1546–1552

    Article  PubMed  CAS  Google Scholar 

  29. Habr-Gama A (2006 Sept) Assessment and management of the complete clinical response of rectal cancer to chemoradiotherapy. Colorectal Dis 8(Suppl 3):21–24

    Article  PubMed  Google Scholar 

  30. Huh JW, Park YA, Jung EJ, Lee KY, Sohn SK (2008 Jul) Accuracy of endorectal ultrasonography and computed tomography for restaging rectal cancer after preoperative chemoradiation. J Am Coll Surg 207(1):7–12

    Article  PubMed  Google Scholar 

  31. Vliegen RF, Beets GL, Lammering G et al (2008 Feb) Mesorectal fascia invasion after neoadjuvant chemotherapy and radiation therapy for locally advanced rectal cancer: accuracy of MR imaging for prediction. Radiology 246(2): 454–462

    Article  PubMed  Google Scholar 

  32. Lahaye M, Beets G, Engelen S et al (2009) Locally advanced rectal cancer:MR Imaging for restaging after neoadjuvant radiation therapy with concomitant chemotherapy. Part II: what are the criteria to predict involved lymph nodes? Radiology 252(1):81–91

    Google Scholar 

  33. Vliegen RF, Beets-Tan RG, Vanhauten B et al (2008 Sept) Can an FDG-PET/CT predict tumor clearance of the mesorectal fascia after preoperative chemoradiation of locally advanced rectal cancer? Strahlenther Onkol 184(9):457–464

    Article  PubMed  Google Scholar 

  34. Capirci C, Rampin L, Erba P et al (2007) Sequential FDG-PET/CT reliably predicts response of locally advanced rectal cancer to neoadjuvant chemo-radiation therapy. Eur J Nucl Med Mol Imaging 34:1583–1593

    Article  PubMed  CAS  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

© 2009 Springer Berlin Heidelberg

About this chapter

Cite this chapter

Gourtsoyianni, S., Beets-Tan, R.G.H. (2009). Rectum. In: Gourtsoyiannis, N. (eds) Clinical MRI of the Abdomen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85689-4_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-85689-4_21

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-85688-7

  • Online ISBN: 978-3-540-85689-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics