MR imaging of the rectum, 3T vs. 1.5T

doi:10.1017/CBO9780511978968.013

Chapter 11 - MR imaging of the rectum, 3T vs. 1.5T

Published online by Cambridge University Press: 05 August 2011

Monique Maas ,

Doenja M. J. Lambregts and

Regina G. H. Beets-Tan

Edited by

Ihab R. Kamel and

Elmar M. Merkle

Show author details

Ihab R. Kamel: Affiliation:
The Johns Hopkins University School of Medicine
Elmar M. Merkle: Affiliation:
Duke University School of Medicine, North Carolina

Book contents

Get access

Summary

Background

Colorectal cancer is the third most common cancer in men and the second most common cancer in women, with an age-adjusted incidence rate of 46.1 per 100 000 per year in the United Kingdom [1]. The estimated number of deaths in the United States in 2009 was 49 920 [2]. Therefore, colorectal cancer has a high impact on health and society. Until now the precise etiology of rectal cancer has not been clarified. It is currently believed that the etiology is multifactorial, with genetic factors on the one hand and environmental factors, such as diet, smoking, and exercise, on the other hand. Patients usually present with rectal bleeding, weight loss, or abdominal complaints. Based on these symptoms a colonoscopy with biopsy is performed, where a tumor is found. Patients then undergo local staging with MR imaging, which has been proven to be the most accurate modality for staging of rectal cancer [3]. Distant staging is performed with computed tomography (CT) of the abdomen and thorax or a combination of a chest X-ray and an ultrasound of the liver. After staging, the patient is discussed in a multidisciplinary team (MDT) meeting, where the risk profile for recurrence is evaluated. A colorectal MDT consists of surgeons, radiation oncologists, medical oncologists, pathologists, gastroenterologists, and radiologists. Over the years, the role of the radiologist in the MDT has evolved from a reporting role to a full sparring partner in clinical decision-making. Because the aim of imaging of rectal cancer is to determine the risk profile of the patient, which defines the type of treatment the patient will undergo, the radiologist nowadays has a crucial influence on the treatment of the patient.

Type: Chapter
Information: Body MR Imaging at 3 Tesla , pp. 150 - 163

DOI: https://doi.org/10.1017/CBO9780511978968.013 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

United Kingdom Cancer Researchhttp://info.cancerresearchuk.org/cancerstats/types/bowel/incidence/index.htm

National Cancer Institute United Stateshttp://www.cancer.gov

Valentini, VAristei, CGlimelius, BMultidisciplinary Rectal Cancer Management: 2nd European Rectal Cancer Consensus Conference (EURECA-CC2)Radiother Oncol 2009 92 148CrossRef Google Scholar

Quirke, PDurdey, PDixon, MFLocal recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumor spread and surgical excisionLancet 1986 2 996CrossRef Google Scholar PubMed

Heald, RJRyall, RDRecurrence and survival after total mesorectal excision for rectal cancerLancet 1986 1 1479CrossRef Google Scholar PubMed

Improved survival with preoperative radiotherapy in resectable rectal cancerSwedish Rectal Cancer TrialN Engl J Med 1997 336 980Google Scholar

Kapiteijn, EMarijnen, CANagtegaal, IDPreoperative radiotherapy combined with total mesorectal excision for resectable rectal cancerN Engl J Med 2001 345 638CrossRef Google Scholar PubMed

Sauer, RBecker, HHohenberger, WPreoperative versus postoperative chemoradiotherapy for rectal cancerN Engl J Med 2004 351 1731CrossRef Google Scholar PubMed

Merkle, EMDale, BMAbdominal MRI at 3T: the basics revisitedAJR Am J Roentgenol 2006 186 1524CrossRef Google Scholar

Slater, AHalligan, STaylor, SADistance between the rectal wall and mesorectal fascia measured by MRI: effect of rectal distension and implications for preoperative prediction of a tumor-free circumferential resection marginClin Radiol 2006 61 65CrossRef Google Scholar

Zhang, XMZhang, HLYu, D3-T MRI of rectal carcinoma: preoperative diagnosis, staging, and planning of sphincter-sparing surgeryAJR Am J Roentgenol 2008 190 1271CrossRef Google Scholar PubMed

Winter, LBruhn, HLangrehr, JMagnetic resonance imaging in suspected rectal cancer: determining tumor localization, stage, and sphincter-saving resectability at 3-Tesla-sustained high resolutionActa Radiol 2007 48 379CrossRef Google Scholar PubMed

Sobin, LGospodarowicz, MWittekind, CTNM Classification of Malignant TumorsChichesterWiley-Blackwell 2009Google Scholar

Beets-Tan, RGBeets, GLVliegen, RFAccuracy of magnetic resonance imaging in prediction of tumor-free resection margin in rectal cancer surgeryLancet 2001 357 497CrossRef Google Scholar

Chun, HKChoi, DKim, MJPreoperative staging of rectal cancer: comparison of 3-T high-field MRI and endorectal sonographyAJR Am J Roentgenol 2006 187 1557CrossRef Google Scholar PubMed

Futterer, JJYakar, DStrijk, SPPreoperative 3T MR imaging of rectal cancer: local staging accuracy using a two-dimensional and three-dimensional T2-weighted turbo spin echo sequenceEur J Radiol 2008 65 66CrossRef Google Scholar PubMed

Kim, HLim, JSChoi, JYRectal cancer: comparison of accuracy of local-regional staging with two- and three-dimensional preoperative 3-T MR imagingRadiology 2010 254 485CrossRef Google Scholar PubMed

Kim, NKKim, MJPark, JKPreoperative staging of rectal cancer with MRI: accuracy and clinical usefulnessAnn Surg Oncol 2000 7 732CrossRef Google Scholar PubMed

Maas, MLambregts, DWildberger, JMR for rectal cancer at 1.5 Tesla is sufficient for T-staging, 3.0 Tesla MR imaging does not necessarily improve radiologist's performanceEur Radiol 2009 19 650Google Scholar

Brown, GRadcliffe, AGNewcombe, RGPreoperative assessment of prognostic factors in rectal cancer using high-resolution magnetic resonance imagingBr J Surg 2003 90 355CrossRef Google Scholar PubMed

Vliegen, RFBeets, GLvon Meyenfeldt, MFRectal cancer: MR imaging in local staging – is gadolinium-based contrast material helpful?Radiology 2005 234 179CrossRef Google Scholar PubMed

Bipat, SGlas, ASSlors, FJRectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging – a meta-analysisRadiology 2004 232 773CrossRef Google Scholar

Lahaye, MJEngelen, SMNelemans, PJImaging for predicting the risk factors – the circumferential resection margin and nodal disease – of local recurrence in rectal cancer: a meta-analysisSemin Ultrasound CT MR 2005 26 259CrossRef Google Scholar PubMed

Dworak, ONumber and size of lymph nodes and node metastases in rectal carcinomasSurg Endosc 1989 3 96CrossRef Google Scholar PubMed

Brown, GRichards, CJBourne, MWMorphologic predictors of lymph node status in rectal cancer with use of high-spatial-resolution MR imaging with histopathologic comparisonRadiology 2003 227 371CrossRef Google Scholar PubMed

Kim, JHBeets, GLKim, MJHigh-resolution MR imaging for nodal staging in rectal cancer: are there any criteria in addition to the size?Eur J Radiol 2004 52 78CrossRef Google Scholar PubMed

Kim, CKKim, SHChun, HKPreoperative staging of rectal cancer: accuracy of 3-Tesla magnetic resonance imagingEur Radiol 2006 16 972CrossRef Google Scholar PubMed

Lahaye, MJEngelen, SMKessels, AGUSPIO-enhanced MR imaging for nodal staging in patients with primary rectal cancer: predictive criteriaRadiology 2008 246 804CrossRef Google Scholar PubMed

Matsuoka, HMasaki, TSugiyama, MMorphological characteristics of lateral pelvic lymph nodes in rectal carcinomaLangenbecks Arch Surg 2007 392 543CrossRef Google Scholar PubMed

Borschitz, TWachtlin, DMohler, MNeoadjuvant chemoradiation and local excision for T2–3 rectal cancerAnn Surg Oncol 2008 15 712CrossRef Google Scholar PubMed

Habr-Gama, APerez, RONadalin, WOperative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term resultsAnn Surg 2004 240 711Google Scholar

Dresen, RCBeets, GLRutten, HJLocally advanced rectal cancer: MR imaging for restaging after neoadjuvant radiation therapy with concomitant chemotherapy. Part I. Are we able to predict tumor confined to the rectal wall?Radiology 2009 252 71CrossRef Google Scholar PubMed

Vliegen, RFBeets, GLLammering, GMesorectal fascia invasion after neoadjuvant chemotherapy and radiation therapy for locally advanced rectal cancer: accuracy of MR imaging for predictionRadiology 2008 246 454CrossRef Google Scholar PubMed

Kuo, LJChern, MCTsou, MHInterpretation of magnetic resonance imaging for locally advanced rectal carcinoma after preoperative chemoradiation therapyDis Colon Rectum 2005 48 23CrossRef Google Scholar PubMed

Kulkarni, TGollins, SMaw, AMagnetic resonance imaging in rectal cancer downstaged using neoadjuvant chemoradiation: accuracy of prediction of tumor stage and circumferential resection margin statusColorectal Dis 2008 10 479CrossRef Google Scholar PubMed

Denecke, TRau, BHoffmann, KTComparison of CT, MRI and FDG-PET in response prediction of patients with locally advanced rectal cancer after multimodal preoperative therapy: is there a benefit in using functional imaging?Eur Radiol 2005 15 1658CrossRef Google Scholar

Lahaye, MJBeets, GLEngelen, SMLocally 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 81CrossRef Google Scholar PubMed

Suppiah, AHunter, IACowley, JMagnetic resonance imaging accuracy in assessing tumor down-staging following chemoradiation in rectal cancerColorectal Dis 2009 11 249CrossRef Google Scholar PubMed

Koh, DMChau, ITait, DEvaluating mesorectal lymph nodes in rectal cancer before and after neoadjuvant chemoradiation using thin-section T2-weighted magnetic resonance imagingInt J Radiat Oncol Biol Phys 2008 71 456CrossRef Google Scholar PubMed

Ptok, HMarusch, FMeyer, FFeasibility and accuracy of TRUS in the pre-treatment staging for rectal carcinoma in general practiceEur J Surg Oncol 2006 32 420CrossRef Google Scholar PubMed

Charles-Edwards, EMdeSouza, NMDiffusion-weighted magnetic resonance imaging and its application to cancerCancer Imaging 2006 6 135CrossRef Google Scholar

Gutzeit, ADoert, AFroehlich, JMComparison of diffusion-weighted whole body MRI and skeletal scintigraphy for the detection of bone metastases in patients with prostate or breast carcinomaSkeletal Radiol 2010 39 333CrossRef Google Scholar PubMed

Nakanishi, KKobayashi, MNakaguchi, KWhole-body MR imaging for detecting metastatic bone tumor: diagnostic value of diffusion-weighted imagesMagn Reson Med Sci 2007 6 147CrossRef Google Scholar PubMed

Ohno, YKoyama, HOnishi, YNon-small cell lung cancer: whole-body MR examination for M-stage assessment – utility for whole-body diffusion-weighted imaging compared with integrated FDG PET/CTRadiology 2008 248 643CrossRef Google Scholar PubMed

Takenaka, DOhno, YMatsumoto, KDetection of bone metastases in non-small cell lung cancer patients: comparison of whole-body diffusion-weighted imaging (DWI), whole-body MR imaging without and with DWI, whole-body FDG-PET/CT, and bone scintigraphyJ Magn Reson Imaging 2009 30 298CrossRef Google Scholar

Kwee, TCvan Ufford, HMBeek, FJWhole-body MRI, including diffusion-weighted imaging, for the initial staging of malignant lymphoma: comparison to computed tomographyInvest Radiol 2009 44 683CrossRef Google Scholar

Squillaci, EManenti, GMancino, SStaging of colon cancer: whole-body MRI vs. whole-body PET-CT – initial clinical experienceAbdom Imaging 2008 33 676CrossRef Google Scholar PubMed

Schmidt, GPBaur-Melnyk, AHaug, AWhole-body MRI at 1.5T and 3T compared with FDG-PET-CT for the detection of tumor recurrence in patients with colorectal cancerEur Radiol 2009 19 1366CrossRef Google Scholar

Coenegrachts, KMatos, Cter Beek, LFocal liver lesion detection and characterization: comparison of non-contrast enhanced and SPIO-enhanced diffusion-weighted single-shot spin echo echo planar and turbo spin echo T2-weighted imagingEur J Radiol 2009 72 432CrossRef Google Scholar PubMed

Nakai, GMatsuki, MInada, YDetection and evaluation of pelvic lymph nodes in patients with gynecologic malignancies using body diffusion-weighted magnetic resonance imagingJ Comput Assist Tomogr 2008 32 764CrossRef Google Scholar PubMed

Sakurada, ATakahara, TKwee, Diagnostic performance of diffusion-weighted magnetic resonance imaging in esophageal cancerEur Radiol 2009 19 1461CrossRef Google Scholar PubMed

Mürtz, PKrautmacher, CTraber, FDiffusion-weighted whole-body MR imaging with background body signal suppression: a feasibility study at 3.0 TeslaEur Radiol 2007 17 3031CrossRef Google Scholar PubMed

Kim, SHLee, JMLee, MWDiagnostic accuracy of 3.0-Tesla rectal magnetic resonance imaging in preoperative local staging of primary rectal cancerInvest Radiol 2008 43 587CrossRef Google Scholar PubMed