Preoperative magnetic resonance imaging assessment of rectal cancer: an overview and update on recent advances_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YUE Yufeng , JIANG Hanyu , HUANG Zixing ,  SONG Bin

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

SONG Bin, Email: cjr.songbin@vip.163.com

Keywords：

rectal cancer; MR imaging; tumor staging; prognostic factor

DOI：

10.7507/1007-9424.201907096

Video：

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Objective To summarize the current status and progress of MR imaging in field of rectal cancer.Methods The recent literatures on this topic were reviewed and analyzed, then the key information they provide was integrated.Results Besides its measurement of tumor height and length, the MR imaging was also significant in the preoperative assessments of tumor staging and prognostic factors such as the extramural vascular invasion (EMVI), circumferential resection margin (CRM), and perineural invasion (PNI). However, some drawbacks couldn’t be neglected. For instance, the conventional MR imaging was of limited use in discriminating T1, T2 and borderline T3 rectal cancer. The similar limitation applies to situation between T3 and T4a rectal cancer as well. And its performances in the N staging prior to and post-neoadjuvant chemoradiation therapy were just average. Currently the functional MR imaging like the diffusion weighted imaging (DWI), some relatively novel modalities such as the dynamic contrast enhanced MRI and chemical shift have served in the radiological diagnosis of the rectal cancer.Conclusions MR imaging is the most frequently used modality in preoperative assessment of rectal cancer. It can describe size and location of tumor, assist in tumor staging, and evaluate prognostic factors. And it is supposed to provide critical information on decision making and prognosis judging. Besides current value of conventional MR imaging in the field of rectal cancer, some innovative techniques have shown moderate potentials as well. Due to their promising future use, detection of new biomarkers regarding rectal cancer can be expected.

Citation： YUE Yufeng, JIANG Hanyu, HUANG Zixing, SONG Bin. Preoperative magnetic resonance imaging assessment of rectal cancer: an overview and update on recent advances. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(9): 1116-1121. doi: 10.7507/1007-9424.201907096 Copy

1.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
2.	Gu J, Chen N. Current status of rectal cancer treatment in China. Colorectal Dis, 2013, 15(11): 1345-1350.
3.	Feng RM, Zong YN, Cao SM, et al. Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics? Cancer Commun (Lond), 2019, 39(1): 22.
4.	Petrillo M, Fusco R, Catalano O, et al. MRI for assessing response to neoadjuvant therapy in locally advanced rectal cancer using DCE-MR and DW-MR data sets: a preliminary report. Biomed Res Int, 2015, 2015: 514740.
5.	Battersby NJ, How P, Moran B, et al. Prospective validation of a low rectal cancer magnetic resonance imaging staging system and development of a local recurrence risk stratification model: The Mercury Ⅱ Study. Ann Surg, 2016, 263(4): 751-760.
6.	Beets-Tan RG, Lambregts DM, Maas M, et al. Magnetic resonance imaging for the clinical management of rectal cancer patients: recommendations from the 2012 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol, 2013, 23(9): 2522-2531.
7.	Gollub MJ, Maas M, Weiser M, et al. Recognition of the anterior peritoneal reflection at rectal MRI. AJR Am J Roentgenol, 2013, 200(1): 97-101.
8.	Nougaret S, Reinhold C, Mikhael HW, et al. The use of MR imaging in treatment planning for patients with rectal carcinoma: have you checked the " DISTANCE”? Radiology, 2013, 268(2): 330-344.
9.	Roodbeen SX, Penna M, Mackenzie H, et al. Transanal total mesorectal excision (TaTME) versus laparoscopic TME for MRI-defined low rectal cancer: a propensity score-matched analysis of oncological outcomes. Surg Endosc, 2019, 33(8): 2459-2467.
10.	Cattapan K, Chulroek T, Wancharoenrung D, et al. Can MR imaging be useful in differentiating low rectal cancer from anal cancer? Abdom Radiol (NY), 2019, 44(2): 438-445.
11.	Tong GJ, Zhang GY, Liu J, et al. Comparison of the eighth version of the American Joint Committee on Cancer manual to the seventh version for colorectal cancer: A retrospective review of our data. World J Clin Oncol, 2018, 9(7): 148-161.
12.	Li F, Zhang W, Li J, et al. The clinical application value of MR diffusion-weighted imaging in the diagnosis of rectal cancer: A retrospective study. Medicine (Baltimore), 2018, 97(51): e13732.
13.	Çolakoğlu Er H, Peker E, Erden A, et al. Rectal cancer confined to the bowel wall: the role of 3 Tesla phased-array MR imaging in T categorization. Br J Radiol, 2018, 91(1082): 20170581.
14.	Maas M, Lambregts DM, Lahaye MJ, et al. T-staging of rectal cancer: accuracy of 3.0 Tesla MRI compared with 1.5 Tesla. Abdom Imaging, 2012, 37(3): 475-481.
15.	Nicholls RJ, Zinicola R, Haboubi N. Extramural spread of rectal cancer and the AJCC Cancer Staging Manual 8th Edition, 2017. Ann Oncol, 2019 May 2. pii: mdz147. doi: 10.1093/annonc/mdz147.
16.	Zinicola R, Pedrazzi G, Haboubi N, et al. The degree of extramural spread of T3 rectal cancer: an appeal to the American Joint Committee on Cancer. Colorectal Dis, 2017, 19(1): 8-15.
17.	Nougaret S, Jhaveri K, Kassam Z, et al. Rectal cancer MR staging: pearls and pitfalls at baseline examination. Abdom Radiol (NY), 2019 May 21. doi: 10.1007/s00261-019-02024-0.
18.	Tong T, Yao Z, Xu L, et al. Extramural depth of tumor invasion at thin-section MR in rectal cancer: associating with prognostic factors and ADC value. J Magn Reson Imaging, 2014, 40(3): 738-744.
19.	Pedersen BG, Moran B, Brown G, et al. Reproducibility of depth of extramural tumor spread and distance to circumferential resection margin at rectal MRI: enhancement of clinical guidelines for neoadjuvant therapy. AJR Am J Roentgenol, 2011, 197(6): 1360-1366.
20.	Gröne J, Loch FN, Taupitz M, et al. Accuracy of various lymph node staging criteria in rectal cancer with magnetic resonance imaging. J Gastrointest Surg, 2018, 22(1): 146-153.
21.	Mizukami Y, Ueda S, Mizumoto A, et al. Diffusion-weighted magnetic resonance imaging for detecting lymph node metastasis of rectal cancer. World J Surg, 2011, 35(4): 895-899.
22.	Attenberger UI, Pilz LR, Morelli JN, et al. Multi-parametric MRI of rectal cancer—do quantitative functional MR measurements correlate with radiologic and pathologic tumor stages? Eur J Radiol, 2014, 83(7): 1036-1043.
23.	Heijnen LA, Lambregts DM, Mondal D, et al. Diffusion-weighted MR imaging in primary rectal cancer staging demonstrates but does not characterise lymph nodes. Eur Radiol, 2013, 23(12): 3354-3360.
24.	Seber T, Caglar E, Uylar T, et al. Diagnostic value of diffusion-weighted magnetic resonance imaging: differentiation of benign and malignant lymph nodes in different regions of the body. Clin Imaging, 2015, 39(5): 856-862.
25.	Tofts PS, Brix G, Buckley DL, et al. Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging, 1999, 10(3): 223-232.
26.	Armbruster M, D'Anastasi M, Holzner V, et al. Improved detection of a tumorous involvement of the mesorectal fascia and locoregional lymph nodes in locally advanced rectal cancer using DCE-MRI. Int J Colorectal Dis, 2018, 33(7): 901-909.
27.	Lahaye MJ, Engelen SM, Kessels AG, et al. USPIO-enhanced MR imaging for nodal staging in patients with primary rectal cancer: predictive criteria. Radiology, 2008, 246(3): 804-811.
28.	Zhang H, Zhang C, Zheng Z, et al. Chemical shift effect predicting lymph node status in rectal cancer using high-resolution MR imaging with node-for-node matched histopathological validation. Eur Radiol, 2017, 27(9): 3845-3855.
29.	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.
30.	Ale Ali H, Kirsch R, Razaz S, et al. Extramural venous invasion in rectal cancer: overview of imaging, histopathology, and clinical implications. Abdom Radiol (NY), 2019, 44(1): 1-10.
31.	Jhaveri KS, Hosseini-Nik H, Thipphavong S, et al. MRI detection of extramural venous invasion in rectal cancer: Correlation with histopathology using elastin stain. AJR Am J Roentgenol, 2016, 206(4): 747-755.
32.	Prampolini F, Taschini S, Pecchi A, et al. Magnetic resonance imaging performed before and after preoperative chemo-radiotherapy in rectal cancer: predictive factors of recurrence and prognostic significance of MR-detected extramural venous invasion. Abdom Radiol (NY), 2018 Nov 27. doi: 10.1007/s00261-018-1838-z.
33.	Siddiqui MRS, Simillis C, Hunter C, et al. A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases. Br J Cancer, 2017, 116(12): 1513-1519.
34.	Kluza E, Kleijnen JP, Martens MH, et al. Non-invasive MR assessment of macroscopic and microscopic vascular abnormalities in the rectal tumour-surrounding mesorectum. Eur Radiol, 2016, 26(5): 1311-1319.
35.	Vliegen RF, Beets GL, Lammering G, et al. Mesorectal fascia invasion after neoadjuvant chemotherapy and radiation therapy for locally advanced rectal cancer: accuracy of MR imaging for prediction. Radiology, 2008, 246(2): 454-462.
36.	Park MJ, Kim SH, Lee SJ, et al. Locally advanced rectal cancer: added value of diffusion-weighted MR imaging for predicting tumor clearance of the mesorectal fascia after neoadjuvant chemotherapy and radiation therapy. Radiology, 2011, 260(3): 771-780.
37.	Kim CH, Yeom SS, Lee SY, et al. Prognostic impact of perineural invasion in rectal cancer after neoadjuvant chemoradiotherapy. World J Surg, 2019, 43(1): 260-272.
38.	Huang Y, He L, Dong D, et al. Individualized prediction of perineural invasion in colorectal cancer: development and validation of a radiomics prediction model. Chin J Cancer Res, 2018, 30(1): 40-50.
39.	Yeo DM, Oh SN, Choi MH, et al. Histogram analysis of perfusion parameters from dynamic contrast-enhanced MR imaging with tumor characteristics and therapeutic response in locally advanced rectal cancer. Biomed Res Int, 2018, 2018: 3724393.
40.	张巍, 黄子星, 张笑, 等. 结直肠癌的放射组学研究进展. 中国普外基础与临床杂志, 2019, 26(4): 484-487.
41.	Granata V, Fusco R, Reginelli A, et al. Diffusion kurtosis imaging in patients with locally advanced rectal cancer: current status and future perspectives. J Int Med Res, 2019, 47(6): 2351-2360.
42.	Yoon J, Chung YE, Lim JS, et al. Quantitative assessment of mesorectal fat: new prognostic biomarker in patients with mid-to-lower rectal cancer. Eur Radiol, 2019, 29(3): 1240-1247.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
2. Gu J, Chen N. Current status of rectal cancer treatment in China. Colorectal Dis, 2013, 15(11): 1345-1350.
3. Feng RM, Zong YN, Cao SM, et al. Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics? Cancer Commun (Lond), 2019, 39(1): 22.
4. Petrillo M, Fusco R, Catalano O, et al. MRI for assessing response to neoadjuvant therapy in locally advanced rectal cancer using DCE-MR and DW-MR data sets: a preliminary report. Biomed Res Int, 2015, 2015: 514740.
5. Battersby NJ, How P, Moran B, et al. Prospective validation of a low rectal cancer magnetic resonance imaging staging system and development of a local recurrence risk stratification model: The Mercury Ⅱ Study. Ann Surg, 2016, 263(4): 751-760.
6. Beets-Tan RG, Lambregts DM, Maas M, et al. Magnetic resonance imaging for the clinical management of rectal cancer patients: recommendations from the 2012 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol, 2013, 23(9): 2522-2531.
7. Gollub MJ, Maas M, Weiser M, et al. Recognition of the anterior peritoneal reflection at rectal MRI. AJR Am J Roentgenol, 2013, 200(1): 97-101.
8. Nougaret S, Reinhold C, Mikhael HW, et al. The use of MR imaging in treatment planning for patients with rectal carcinoma: have you checked the " DISTANCE”? Radiology, 2013, 268(2): 330-344.
9. Roodbeen SX, Penna M, Mackenzie H, et al. Transanal total mesorectal excision (TaTME) versus laparoscopic TME for MRI-defined low rectal cancer: a propensity score-matched analysis of oncological outcomes. Surg Endosc, 2019, 33(8): 2459-2467.
10. Cattapan K, Chulroek T, Wancharoenrung D, et al. Can MR imaging be useful in differentiating low rectal cancer from anal cancer? Abdom Radiol (NY), 2019, 44(2): 438-445.
11. Tong GJ, Zhang GY, Liu J, et al. Comparison of the eighth version of the American Joint Committee on Cancer manual to the seventh version for colorectal cancer: A retrospective review of our data. World J Clin Oncol, 2018, 9(7): 148-161.
12. Li F, Zhang W, Li J, et al. The clinical application value of MR diffusion-weighted imaging in the diagnosis of rectal cancer: A retrospective study. Medicine (Baltimore), 2018, 97(51): e13732.
13. Çolakoğlu Er H, Peker E, Erden A, et al. Rectal cancer confined to the bowel wall: the role of 3 Tesla phased-array MR imaging in T categorization. Br J Radiol, 2018, 91(1082): 20170581.
14. Maas M, Lambregts DM, Lahaye MJ, et al. T-staging of rectal cancer: accuracy of 3.0 Tesla MRI compared with 1.5 Tesla. Abdom Imaging, 2012, 37(3): 475-481.
15. Nicholls RJ, Zinicola R, Haboubi N. Extramural spread of rectal cancer and the AJCC Cancer Staging Manual 8th Edition, 2017. Ann Oncol, 2019 May 2. pii: mdz147. doi: 10.1093/annonc/mdz147.
16. Zinicola R, Pedrazzi G, Haboubi N, et al. The degree of extramural spread of T3 rectal cancer: an appeal to the American Joint Committee on Cancer. Colorectal Dis, 2017, 19(1): 8-15.
17. Nougaret S, Jhaveri K, Kassam Z, et al. Rectal cancer MR staging: pearls and pitfalls at baseline examination. Abdom Radiol (NY), 2019 May 21. doi: 10.1007/s00261-019-02024-0.
18. Tong T, Yao Z, Xu L, et al. Extramural depth of tumor invasion at thin-section MR in rectal cancer: associating with prognostic factors and ADC value. J Magn Reson Imaging, 2014, 40(3): 738-744.
19. Pedersen BG, Moran B, Brown G, et al. Reproducibility of depth of extramural tumor spread and distance to circumferential resection margin at rectal MRI: enhancement of clinical guidelines for neoadjuvant therapy. AJR Am J Roentgenol, 2011, 197(6): 1360-1366.
20. Gröne J, Loch FN, Taupitz M, et al. Accuracy of various lymph node staging criteria in rectal cancer with magnetic resonance imaging. J Gastrointest Surg, 2018, 22(1): 146-153.
21. Mizukami Y, Ueda S, Mizumoto A, et al. Diffusion-weighted magnetic resonance imaging for detecting lymph node metastasis of rectal cancer. World J Surg, 2011, 35(4): 895-899.
22. Attenberger UI, Pilz LR, Morelli JN, et al. Multi-parametric MRI of rectal cancer—do quantitative functional MR measurements correlate with radiologic and pathologic tumor stages? Eur J Radiol, 2014, 83(7): 1036-1043.
23. Heijnen LA, Lambregts DM, Mondal D, et al. Diffusion-weighted MR imaging in primary rectal cancer staging demonstrates but does not characterise lymph nodes. Eur Radiol, 2013, 23(12): 3354-3360.
24. Seber T, Caglar E, Uylar T, et al. Diagnostic value of diffusion-weighted magnetic resonance imaging: differentiation of benign and malignant lymph nodes in different regions of the body. Clin Imaging, 2015, 39(5): 856-862.
25. Tofts PS, Brix G, Buckley DL, et al. Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging, 1999, 10(3): 223-232.
26. Armbruster M, D'Anastasi M, Holzner V, et al. Improved detection of a tumorous involvement of the mesorectal fascia and locoregional lymph nodes in locally advanced rectal cancer using DCE-MRI. Int J Colorectal Dis, 2018, 33(7): 901-909.
27. Lahaye MJ, Engelen SM, Kessels AG, et al. USPIO-enhanced MR imaging for nodal staging in patients with primary rectal cancer: predictive criteria. Radiology, 2008, 246(3): 804-811.
28. Zhang H, Zhang C, Zheng Z, et al. Chemical shift effect predicting lymph node status in rectal cancer using high-resolution MR imaging with node-for-node matched histopathological validation. Eur Radiol, 2017, 27(9): 3845-3855.
29. 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.
30. Ale Ali H, Kirsch R, Razaz S, et al. Extramural venous invasion in rectal cancer: overview of imaging, histopathology, and clinical implications. Abdom Radiol (NY), 2019, 44(1): 1-10.
31. Jhaveri KS, Hosseini-Nik H, Thipphavong S, et al. MRI detection of extramural venous invasion in rectal cancer: Correlation with histopathology using elastin stain. AJR Am J Roentgenol, 2016, 206(4): 747-755.
32. Prampolini F, Taschini S, Pecchi A, et al. Magnetic resonance imaging performed before and after preoperative chemo-radiotherapy in rectal cancer: predictive factors of recurrence and prognostic significance of MR-detected extramural venous invasion. Abdom Radiol (NY), 2018 Nov 27. doi: 10.1007/s00261-018-1838-z.
33. Siddiqui MRS, Simillis C, Hunter C, et al. A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases. Br J Cancer, 2017, 116(12): 1513-1519.
34. Kluza E, Kleijnen JP, Martens MH, et al. Non-invasive MR assessment of macroscopic and microscopic vascular abnormalities in the rectal tumour-surrounding mesorectum. Eur Radiol, 2016, 26(5): 1311-1319.
35. Vliegen RF, Beets GL, Lammering G, et al. Mesorectal fascia invasion after neoadjuvant chemotherapy and radiation therapy for locally advanced rectal cancer: accuracy of MR imaging for prediction. Radiology, 2008, 246(2): 454-462.
36. Park MJ, Kim SH, Lee SJ, et al. Locally advanced rectal cancer: added value of diffusion-weighted MR imaging for predicting tumor clearance of the mesorectal fascia after neoadjuvant chemotherapy and radiation therapy. Radiology, 2011, 260(3): 771-780.
37. Kim CH, Yeom SS, Lee SY, et al. Prognostic impact of perineural invasion in rectal cancer after neoadjuvant chemoradiotherapy. World J Surg, 2019, 43(1): 260-272.
38. Huang Y, He L, Dong D, et al. Individualized prediction of perineural invasion in colorectal cancer: development and validation of a radiomics prediction model. Chin J Cancer Res, 2018, 30(1): 40-50.
39. Yeo DM, Oh SN, Choi MH, et al. Histogram analysis of perfusion parameters from dynamic contrast-enhanced MR imaging with tumor characteristics and therapeutic response in locally advanced rectal cancer. Biomed Res Int, 2018, 2018: 3724393.
40. 张巍, 黄子星, 张笑, 等. 结直肠癌的放射组学研究进展. 中国普外基础与临床杂志, 2019, 26(4): 484-487.
41. Granata V, Fusco R, Reginelli A, et al. Diffusion kurtosis imaging in patients with locally advanced rectal cancer: current status and future perspectives. J Int Med Res, 2019, 47(6): 2351-2360.
42. Yoon J, Chung YE, Lim JS, et al. Quantitative assessment of mesorectal fat: new prognostic biomarker in patients with mid-to-lower rectal cancer. Eur Radiol, 2019, 29(3): 1240-1247.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Preoperative magnetic resonance imaging assessment of rectal cancer: an overview and update on recent advances

Abstract Full text Figures/Tables Video References Cited by

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