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Mastering rectal cancer MRI: From foundational concepts to optimal staging
Journal article   Peer reviewed

Mastering rectal cancer MRI: From foundational concepts to optimal staging

Carolina Augusta Modena Heming, Janet A. Alvarez, Joao Miranda, Daniel Cardoso, Carolina Lorenzoni Almeida Ghezzi, Gerda F. Nogueira, Luciana Costa-Silva, Rodrigo Sanford Damasceno, Tiago Oliveira Morita, J. Joshua Smith, …
European journal of radiology, Vol.183, 111937
02/2025
DOI: 10.1016/j.ejrad.2025.111937
PMCID: PMC12168187
PMID: 39864243

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Abstract

MRI plays a critical role in the local staging, restaging, surveillance, and risk stratification of patients, ensuring they receive the most tailored therapy. As such, radiologists must be familiar not only with the key MRI findings that influence management decisions but also with the appropriate MRI protocols and structured reporting. Given the complexity of selecting the optimal therapy for each patient—which often requires multidisciplinary discussions—radiologists should be well-versed in relevant treatment strategies and surgical terms, understanding their significance in guiding patient care. In this manuscript, we review the most common treatment options for managing patients with rectal adenocarcinoma, emphasizing key MRI principles and protocol characteristics for accurate staging. We also highlight important anatomical landmarks and essential factors to be described during baseline assessment. Additionally, we discuss crucial information for restaging and surveillance.
Magnetic Resonance Imaging Rectal Neoplasms Rectal cancer Neoplasm Staging Neoadjuvant Therapy

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