ObjectivesTo update the 2012 ESGAR consensus guidelines on the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer.MethodsFourteen abdominal imaging experts from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) participated in a consensus meeting, organised according to an adaptation of the RAND-UCLA Appropriateness Method. Two independent (non-voting) Chairs facilitated the meeting. 246 items were scored (comprising 229 items from the previous 2012 consensus and 17 additional items) and classified as ‘appropriate’ or ‘inappropriate’ (defined by ≥ 80 % consensus) or uncertain (defined by < 80 % consensus).ResultsConsensus was reached for 226 (92 %) of items. From these recommendations regarding hardware, patient preparation, imaging sequences and acquisition, criteria for MR imaging evaluation and reporting structure were constructed. The main additions to the 2012 consensus include recommendations regarding use of diffusion-weighted imaging, criteria for nodal staging and a recommended structured report template.ConclusionsThese updated expert consensus recommendations should be used as clinical guidelines for primary staging and restaging of rectal cancer using MRI.Key Points• These guidelines present recommendations for staging and reporting of rectal cancer.
• The guidelines were constructed through consensus amongst 14 pelvic imaging experts.
• Consensus was reached by the experts for 92 % of the 246 items discussed.
• Practical guidelines for nodal staging are proposed.
• A structured reporting template is presented.
Electronic supplementary materialThe online version of this article (10.1007/s00330-017-5026-2) contains supplementary material, which is available to authorized users.
Computed tomographic (CT) colonography continues to evolve rapidly. Advances in scanning and display technologies, encouraging performance data, and increased utilization necessitate clarification and standardization of results reporting in CT colonography. There are several reasons for this. First and most important, standardized reporting can better assist patients and referring physi-cians in making management decisions on the basis of the results of CT colonography. The precedent of the mammography Breast Imaging Reporting and Data System, or BI-RADS, schema is a strong incentive to provide a similar structure for CT colonography. Second, as more examinations are performed, the likelihood increases that radiologists interpreting results of a CT colonography examination performed at one center will require comparison to examination results and reports generated at other sites. As has been seen with mammography, a common set of terms facilitates this kind of assessment (1). Third, as utilization of CT colonography increases, our colleagues in other medical specialties, the various third-party payers, and the general public will insist on larger-scale evaluations of examination performance, examination quality, patient outcome, and cost. Here again, a common approach to interpretation will assist us in meeting these demands. Finally, a common scheme for reporting facilitates structured reporting.The purpose of this communication is to facilitate clear and consistent communication of CT colonography results. The authors-an ad hoc group of investigators active in the area of CT colonogra-
In a group of patients at high risk for colorectal neoplasia, virtual and conventional colonoscopy had similar efficacy for the detection of polyps that were 6 mm or more in diameter.
• These guidelines recommend standardised imaging for staging and restaging of rectal cancer. • The guidelines were constructed through consensus amongst 14 abdominal imaging experts. • Consensus was reached by in 88 % of 236 items discussed.
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