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Accurate staging by high-resolution magnetic resonance imaging (MRI) is pivotal to the multidisciplinary management of rectal cancer. Aside from tumour and lymph node staging, high-resolution MRI can identify other imaging prognosticators to stratify patients to different prognostic groups for different treatment. These imaging prognosticators include circumferential resection margin, extramural venous invasion, extramural depth of tumour extension, vascular / tumour deposits, mucinous primary tumour, and relationship to the intersphincteric plane (in low-rectal tumours). This review describes the imaging features and prognostic impact of these MRI-detected biomarkers.

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