Application Progress of MRI in Assessment of Rectal Cancer Before Surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 CHENYong ¹ ,  ZHENGBao-jun ²

1. 1.College of Graduate, North China University of Science and Technology, Tangshan 063000, Hebei Province, China;
2. 2.Department of OncologySurgery, Tangshan Worker Hospital, Tangshan 063000, Hebei Province, China;

Corresponding author：

ZHENGBao-jun, Email: baojunz59@163.com

Keywords：

Magnetic resonance imaging; Rectal cancer; Preoperative staging; Circumferential resection margin; Extramural vascular invasion

DOI：

10.7507/1007-9424.20160201

Video：

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Objective To summarize the research progress of MRI in the assessment of rectal cancer before surgery. Methods Literatures about the recent studies on the research progress of MRI in the assessment of rectal cancer before surgery were reviewed according to the results searched from Pubmed, CNKI, and WanFang database. Results Preoperative staging, circumferential resection margin, and extramural vascular invasion were closely related to the prognosis of rectal cancer patients, MRI could provide a good assessment of preoperative staging, circumferential resection margin, and extramural vascular invasion for rectal cancer patients, but it still had some deficiencies which needed further studies. Conclusion Application of MRI in the assessment of preoperative staging, circumferential resection margin, and extramural vascular invasion before surgery, is conducive to the development of the most appropriate treatment options for patients with rectal cancer.

Citation： CHENYong, ZHENGBao-jun. Application Progress of MRI in Assessment of Rectal Cancer Before Surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(6): 767-771. doi: 10.7507/1007-9424.20160201 Copy

1.	Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin, 2013, 63(1): 11-30.
2.	Furey E, Jhaveri KS. Magnetic resonance imaging in rectal cancer. Magn Reson Imaging Clin N Am, 2014, 22(2): 165-190.
3.	Dewhurst CE, Mortele KJ. Magnetic resonance imaging of rectal cancer. Radiol Clin North Am, 2013, 51(1): 121-131.
4.	Kekelidze M, D’Errico L, Pansini M, et al. Colorectal cancer: current imaging methods and future perspectives for the diagnosis, staging and therapeutic response evaluation. World J Gastroenterol, 2013, 19(46): 8502-8514.
5.	Samdani T, Garcia-Aguilar J. Imaging in rectal cancer magnetic resonance imaging versus endorectal ultrasonography. Surg Oncol Clin N Am, 2014, 23(1): 59-77.
6.	Kaur H, Choi H, You YN, et al. MR imaging for preoperative evaluation of primary rectal cancer: practical considerations. Radiographics, 2012, 32(2): 389-409.
7.	Merkel S, Mansmann U, Siassi M, et al. The prognostic inhomogeneity in pT3 rectal carcinomas. Int J Colorectal Dis, 2001, 16(5): 298-304.
8.	Beaumont C, Pandey T, Gaines Fricke R, et al. MR evaluation of rectal cancer: current concepts. Curr Probl Diagn Radiol, 2013, 42(3): 99-112.
9.	杨记华, 高雪梅, 程敬亮, 等. 磁共振弥散加权成像联合常规序列在直肠癌T 分期诊断中的应用. 郑州大学学报: 医学版, 2012, 47(2): 244-246.
10.	陆志华, 钱伟新, 曹文洪, 等. 磁共振扩散加权成像对直肠癌T 分期的诊断价值. 中华胃肠外科杂志, 2015, 18(3): 257-261.
11.	戴峥, 文戈, 胡培铅, 等. 3.0T 高分辨率MRI 在直肠癌术前T 分期中的应用价值. 中国医疗设备, 2015, 30(9): 51-53.
12.	DePrisco G. MRI local staging and restaging in rectal cancer. Clin Colon Rectal Surg, 2015, 28(3): 194-200.
13.	Boone D, Taylor SA, Halligan S. Diffusion weighted MRI: overview and implications for rectal cancer management. Colorectal Dis, 2013, 15(6): 655-661.
14.	Beets-Tan RG. Pretreatment MRI of lymph nodes in rectal cancer: an opinion-based review. Colorectal Dis, 2013, 15(7): 781-784.
15.	田博, 杨得振, 贾勇, 等. CT、MRI 影像诊断对直肠癌临床术前分期价值研究. 中国CT 和MRI 杂志, 2015, 13(11): 108-110, 114.
16.	路成文, 张彬. CT、MR 对盆腔结、直肠癌术前TN 分期的应用价值. 医学影像学杂志, 2015, 25(7): 1204-1208, 1220.
17.	Brown G, Richards CJ, Bourne MW, et al. Morphologic predictors of lymph node status in rectal cancer with use of high-spatialresolution MR imaging with histopathologic comparison. Radiology, 2003, 227(2): 371-377.18 Yamada I, Yoshino N, Tetsumura A, et al. Colorectal carcinoma: local tumor staging and assessment of lymph node metastasis by high-resolution MR imaging in surgical specimens. Int J Biomed Imaging, 2009, 2009: 659836.
18.	Yamada I, Yoshino N, Tetsumura A, et al. Colorectal carcinoma:local tumor staging and assessment of lymph node metastasis byhigh-resolution MR imaging in surgical specimens. Int J BiomedImaging, 2009, 2009: 659836.
19.	Mir N, Sohaib SA, Collins D, et al. Fusion of high b-value diffusionweighted and T2-weighted MR images improves identification of lymph nodes in the pelvis. J Med Imaging Radiat Oncol, 2010, 54(4): 358-364.
20.	Will O, Purkayastha S, Chan C, et al. Diagnostic precision of nanoparticle-enhanced MRI for lymph-node metastases: a metaanalysis. Lancet Oncol, 2006, 7(1): 52-60.
21.	Lahaye MJ, Beets GL, Engelen SM, et al. 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, 2009, 252(1): 81-91.
22.	Koh DM, George C, Temple L, et al. Diagnostic accuracy of nodal enhancement pattern of rectal cancer at MRI enhanced with ultrasmall superparamagnetic iron oxide: findings in pathologically matched mesorectal lymph nodes. AJR Am J Roentgenol, 2010, 194(6): W505-W513.
23.	Lambregts DM, Beets GL, Maas M, et al. Accuracy of gadofosvesetenhanced MRI for nodal staging and restaging in rectal cancer. Ann Surg, 2011, 253(3): 539-545.
24.	Lambregts DM, Heijnen LA, Maas M, et al. Gadofosveset-enhanced MRI for the assessment of rectal cancer lymph nodes: predictive criteria. Abdom Imaging, 2013, 38(4): 720-727.
25.	Quirke P, Durdey P, Dixon MF, et al. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet, 1986, 2(8514): 996-999.
26.	Hermanek P, Junginger T. The circumferential resection margin in rectal carcinoma surgery. Tech Coloproctol, 2005, 9(3): 193-200.
27.	Ma X, Li X, Xu L, et al. Characteristics and prognostic significance of preoperative magnetic resonance imaging-assessed circumferential margin in rectal cancer. Gastroenterol Res Pract, 2015, 2015: 410150.
28.	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): 303-312.
29.	Beets-Tan RG, Beets GL. Local staging of rectal cancer: a review of imaging. J Magn Reson Imaging, 2011, 33(5): 1012-1019.
30.	Al-Sukhni E, Milot L, Fruitman M, et al. Diagnostic accuracy of MRI for assessment of T category, lymph node metastases, and circumferential resection margin involvement in patients with rectal cancer: a systematic review and meta-analysis. Ann Surg Oncol, 2012, 19(7): 2212-2223.
31.	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.
32.	丛冠宁, 秦明伟, 贺丹, 等. 高分辨MRI 对直肠癌TNM 分期及环周切缘的评估. 中国普外基础与临床杂志, 2010, 17(9): 894-900.
33.	Taylor FG, Quirke P, Heald RJ, et al. One millimetre is the safe cutoff for magnetic resonance imaging prediction of surgical margin status in rectal cancer. Br J Surg, 2011, 98(6): 872-879.
34.	顾晋, 王林. 中低位直肠癌环周切缘的规范化检测. 中华胃肠外科杂志, 2011, 14(4): 229-232.
35.	Taflampas P, Christodoulakis M, De Bree E, et al. Preoperative decision making for rectal cancer. Am J Surg, 2010, 200(3): 426-432.
36.	Simunovic M, Sexton R, Rempel E, et al. Optimal preoperative assessment and surgery for rectal cancer may greatly limit the need for radiotherapy. Br J Surg, 2003, 90(8): 999-1003.
37.	Cecil TD, Sexton R, Moran BJ, et al. Total mesorectal excision results in low local recurrence rates in lymph node-positive rectal cancer. Dis Colon Rectum, 2004, 47(7): 1145-1150.
38.	Talbot IC, Ritchie S, Leighton MH, et al. The clinical significance of invasion of veins by rectal cancer. Br J Surg, 1980, 67(6): 439-442.
39.	Betge J, Pollheimer MJ, Lindtner RA, et al. Intramural and extramural vascular invasion in colorectal cancer: prognostic significance and quality of pathology reporting. Cancer, 2012, 118(3): 628-638.
40.	Smith NJ, Shihab O, Arnaout A, et al. MRI for detection of extramural vascular invasion in rectal cancer. AJR Am J Roentgenol, 2008, 191(5): 1517-1522.
41.	Brown G, Radcliffe AG, Newcombe RG, et al. Preoperative assessment of prognostic factors in rectal cancer using high-resolution magnetic resonance imaging. Br J Surg, 2003, 90(3): 355-364.
42.	MERCURY Study Group. Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. BMJ, 2006, 333(7572): 779.
43.	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): 132-139.
44.	Smith NJ, Barbachano Y, Norman AR, et al. Prognostic significance of magnetic resonance imaging-detected extramural vascular invasion in rectal cancer. Br J Surg, 2008, 95(2): 229-236.
45.	Sohn B, Lim JS, Kim H, et al. MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer. Eur Radiol, 2015, 25(5): 1347-1355.
46.	Lim SB, Yu CS, Jang SJ, et al. Prognostic significance of lymphovascular invasion in sporadic colorectal cancer. Dis Colon Rectum, 2010, 53(4): 377-384.
47.	Messenger DE, Driman DK, Kirsch R. Developments in the assessment of venous invasion in colorectal cancer: implications for future practice and patient outcome. Hum Pathol, 2012, 43(7): 965-973.
48.	Hunter CJ, Garant A, Vuong T, et al. Adverse features on rectal MRI identify a high-risk group that may benefit from more intensive preoperative staging and treatment. Ann Surg Oncol, 2012, 19(4): 1199-1205.
49.	Bugg WG, Andreou AK, Biswas D, et al. The prognostic significance of MRI-detected extramural venous invasion in rectal carcinoma. Clin Radiol, 2014, 69(6): 619-623.

1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin, 2013, 63(1): 11-30.
2. Furey E, Jhaveri KS. Magnetic resonance imaging in rectal cancer. Magn Reson Imaging Clin N Am, 2014, 22(2): 165-190.
3. Dewhurst CE, Mortele KJ. Magnetic resonance imaging of rectal cancer. Radiol Clin North Am, 2013, 51(1): 121-131.
4. Kekelidze M, D’Errico L, Pansini M, et al. Colorectal cancer: current imaging methods and future perspectives for the diagnosis, staging and therapeutic response evaluation. World J Gastroenterol, 2013, 19(46): 8502-8514.
5. Samdani T, Garcia-Aguilar J. Imaging in rectal cancer magnetic resonance imaging versus endorectal ultrasonography. Surg Oncol Clin N Am, 2014, 23(1): 59-77.
6. Kaur H, Choi H, You YN, et al. MR imaging for preoperative evaluation of primary rectal cancer: practical considerations. Radiographics, 2012, 32(2): 389-409.
7. Merkel S, Mansmann U, Siassi M, et al. The prognostic inhomogeneity in pT3 rectal carcinomas. Int J Colorectal Dis, 2001, 16(5): 298-304.
8. Beaumont C, Pandey T, Gaines Fricke R, et al. MR evaluation of rectal cancer: current concepts. Curr Probl Diagn Radiol, 2013, 42(3): 99-112.
9. 杨记华, 高雪梅, 程敬亮, 等. 磁共振弥散加权成像联合常规序列在直肠癌T 分期诊断中的应用. 郑州大学学报: 医学版, 2012, 47(2): 244-246.
10. 陆志华, 钱伟新, 曹文洪, 等. 磁共振扩散加权成像对直肠癌T 分期的诊断价值. 中华胃肠外科杂志, 2015, 18(3): 257-261.
11. 戴峥, 文戈, 胡培铅, 等. 3.0T 高分辨率MRI 在直肠癌术前T 分期中的应用价值. 中国医疗设备, 2015, 30(9): 51-53.
12. DePrisco G. MRI local staging and restaging in rectal cancer. Clin Colon Rectal Surg, 2015, 28(3): 194-200.
13. Boone D, Taylor SA, Halligan S. Diffusion weighted MRI: overview and implications for rectal cancer management. Colorectal Dis, 2013, 15(6): 655-661.
14. Beets-Tan RG. Pretreatment MRI of lymph nodes in rectal cancer: an opinion-based review. Colorectal Dis, 2013, 15(7): 781-784.
15. 田博, 杨得振, 贾勇, 等. CT、MRI 影像诊断对直肠癌临床术前分期价值研究. 中国CT 和MRI 杂志, 2015, 13(11): 108-110, 114.
16. 路成文, 张彬. CT、MR 对盆腔结、直肠癌术前TN 分期的应用价值. 医学影像学杂志, 2015, 25(7): 1204-1208, 1220.
17. Brown G, Richards CJ, Bourne MW, et al. Morphologic predictors of lymph node status in rectal cancer with use of high-spatialresolution MR imaging with histopathologic comparison. Radiology, 2003, 227(2): 371-377.18 Yamada I, Yoshino N, Tetsumura A, et al. Colorectal carcinoma: local tumor staging and assessment of lymph node metastasis by high-resolution MR imaging in surgical specimens. Int J Biomed Imaging, 2009, 2009: 659836.
18. Yamada I, Yoshino N, Tetsumura A, et al. Colorectal carcinoma:local tumor staging and assessment of lymph node metastasis byhigh-resolution MR imaging in surgical specimens. Int J BiomedImaging, 2009, 2009: 659836.
19. Mir N, Sohaib SA, Collins D, et al. Fusion of high b-value diffusionweighted and T2-weighted MR images improves identification of lymph nodes in the pelvis. J Med Imaging Radiat Oncol, 2010, 54(4): 358-364.
20. Will O, Purkayastha S, Chan C, et al. Diagnostic precision of nanoparticle-enhanced MRI for lymph-node metastases: a metaanalysis. Lancet Oncol, 2006, 7(1): 52-60.
21. Lahaye MJ, Beets GL, Engelen SM, et al. 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, 2009, 252(1): 81-91.
22. Koh DM, George C, Temple L, et al. Diagnostic accuracy of nodal enhancement pattern of rectal cancer at MRI enhanced with ultrasmall superparamagnetic iron oxide: findings in pathologically matched mesorectal lymph nodes. AJR Am J Roentgenol, 2010, 194(6): W505-W513.
23. Lambregts DM, Beets GL, Maas M, et al. Accuracy of gadofosvesetenhanced MRI for nodal staging and restaging in rectal cancer. Ann Surg, 2011, 253(3): 539-545.
24. Lambregts DM, Heijnen LA, Maas M, et al. Gadofosveset-enhanced MRI for the assessment of rectal cancer lymph nodes: predictive criteria. Abdom Imaging, 2013, 38(4): 720-727.
25. Quirke P, Durdey P, Dixon MF, et al. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet, 1986, 2(8514): 996-999.
26. Hermanek P, Junginger T. The circumferential resection margin in rectal carcinoma surgery. Tech Coloproctol, 2005, 9(3): 193-200.
27. Ma X, Li X, Xu L, et al. Characteristics and prognostic significance of preoperative magnetic resonance imaging-assessed circumferential margin in rectal cancer. Gastroenterol Res Pract, 2015, 2015: 410150.
28. 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): 303-312.
29. Beets-Tan RG, Beets GL. Local staging of rectal cancer: a review of imaging. J Magn Reson Imaging, 2011, 33(5): 1012-1019.
30. Al-Sukhni E, Milot L, Fruitman M, et al. Diagnostic accuracy of MRI for assessment of T category, lymph node metastases, and circumferential resection margin involvement in patients with rectal cancer: a systematic review and meta-analysis. Ann Surg Oncol, 2012, 19(7): 2212-2223.
31. 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.
32. 丛冠宁, 秦明伟, 贺丹, 等. 高分辨MRI 对直肠癌TNM 分期及环周切缘的评估. 中国普外基础与临床杂志, 2010, 17(9): 894-900.
33. Taylor FG, Quirke P, Heald RJ, et al. One millimetre is the safe cutoff for magnetic resonance imaging prediction of surgical margin status in rectal cancer. Br J Surg, 2011, 98(6): 872-879.
34. 顾晋, 王林. 中低位直肠癌环周切缘的规范化检测. 中华胃肠外科杂志, 2011, 14(4): 229-232.
35. Taflampas P, Christodoulakis M, De Bree E, et al. Preoperative decision making for rectal cancer. Am J Surg, 2010, 200(3): 426-432.
36. Simunovic M, Sexton R, Rempel E, et al. Optimal preoperative assessment and surgery for rectal cancer may greatly limit the need for radiotherapy. Br J Surg, 2003, 90(8): 999-1003.
37. Cecil TD, Sexton R, Moran BJ, et al. Total mesorectal excision results in low local recurrence rates in lymph node-positive rectal cancer. Dis Colon Rectum, 2004, 47(7): 1145-1150.
38. Talbot IC, Ritchie S, Leighton MH, et al. The clinical significance of invasion of veins by rectal cancer. Br J Surg, 1980, 67(6): 439-442.
39. Betge J, Pollheimer MJ, Lindtner RA, et al. Intramural and extramural vascular invasion in colorectal cancer: prognostic significance and quality of pathology reporting. Cancer, 2012, 118(3): 628-638.
40. Smith NJ, Shihab O, Arnaout A, et al. MRI for detection of extramural vascular invasion in rectal cancer. AJR Am J Roentgenol, 2008, 191(5): 1517-1522.
41. Brown G, Radcliffe AG, Newcombe RG, et al. Preoperative assessment of prognostic factors in rectal cancer using high-resolution magnetic resonance imaging. Br J Surg, 2003, 90(3): 355-364.
42. MERCURY Study Group. Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. BMJ, 2006, 333(7572): 779.
43. 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): 132-139.
44. Smith NJ, Barbachano Y, Norman AR, et al. Prognostic significance of magnetic resonance imaging-detected extramural vascular invasion in rectal cancer. Br J Surg, 2008, 95(2): 229-236.
45. Sohn B, Lim JS, Kim H, et al. MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer. Eur Radiol, 2015, 25(5): 1347-1355.
46. Lim SB, Yu CS, Jang SJ, et al. Prognostic significance of lymphovascular invasion in sporadic colorectal cancer. Dis Colon Rectum, 2010, 53(4): 377-384.
47. Messenger DE, Driman DK, Kirsch R. Developments in the assessment of venous invasion in colorectal cancer: implications for future practice and patient outcome. Hum Pathol, 2012, 43(7): 965-973.
48. Hunter CJ, Garant A, Vuong T, et al. Adverse features on rectal MRI identify a high-risk group that may benefit from more intensive preoperative staging and treatment. Ann Surg Oncol, 2012, 19(4): 1199-1205.
49. Bugg WG, Andreou AK, Biswas D, et al. The prognostic significance of MRI-detected extramural venous invasion in rectal carcinoma. Clin Radiol, 2014, 69(6): 619-623.

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