Rectal cancer - local staging and imaging under neoadjuvant therapy

Rectal cancer restaging after neoadjuvant therapy is based on two principles: an anatomic definition of the tumor allowing surgical planning and prognostic stage grouping. Emerging data suggest that reassessment using a combination of different imaging modalities may help to provide valuable prognos...

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Bibliographic Details
Published in:Radiologe 2012-06, Vol.52 (6), p.519-528
Main Author: Karpitschka, M
Format: Article
Language:ger
Subjects:
Humans
Magnetic Resonance Imaging - methods
Neoadjuvant Therapy
Neoplasm Staging
Prognosis
Rectal Neoplasms - pathology
Rectal Neoplasms - therapy
Tomography, X-Ray Computed - methods
Treatment Outcome
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Summary:Rectal cancer restaging after neoadjuvant therapy is based on two principles: an anatomic definition of the tumor allowing surgical planning and prognostic stage grouping. Emerging data suggest that reassessment using a combination of different imaging modalities may help to provide valuable prognostic information before definitive surgery. Perfusion computed tomography (CT) may provide special information regarding tumor vascularity. Evaluation of therapy response, especially of the circumferential resection margin (CRM) is necessary for surgical planning. For local staging high-resolution and diffusion-weighted magnetic resonance imaging has proven to be of high diagnostic accuracy. The M status should be assessed using multidetector computed tomography (MDCT) according to response evaluation criteria in solid tumors (RECIST) while lymph node evaluation requires either magnetic resonance imaging or positron emission tomography/computed tomography scanning.
ISSN:1432-2102
DOI:10.1007/s00117-011-2283-y