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The role of MRI in the pre-operative staging of rectal cancer

Department of Radiology, University Hospital of Wales, Heath Park, Cardiff CF4 4XN, UK

Summary

Pre-operative local staging in patients with rectal cancer can be used to:

• Assign the most appropriate pre-operative adjuvant therapy;
  
• Assist in surgical planning;
  
• Serve as an accurate baseline from which to compare the success of different treatment strategies.
  

In image interpretation, the following prognostic information should be sought:

• Tumour T stage;
  
• The depth of extramural spread of tumour (depth beyond outer muscle wall);
  
• The relationship of the tumour to the peritoneal reflection;
  
• The relationship of the tumour to the anal sphincter complex;
  
• The distance from the outermost edge of the tumour to the mesorectal fascia;
  
• The presence and location of mesorectal deposits;
  
• The presence of other prognostic factors, such as extramural venous invasion and peritoneal invasion.
  

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