JOURNAL CLUB: Preoperative MRI Evaluation of Primary Rectal Cancer: Intrasubject Comparison With and Without Rectal Distention

Abstract

Rectal distention significantly improved visualization of tumors on MR images. It also improved T category assessment to some extent. Although the distance between normal rectal wall and MRF was significantly less with rectal distention than without rectal distention, maximal extramural depth and the distance between tumor and MRF did not vary significantly with or without rectal distention.

The influence of endorectal filling on rectal cancer staging with MRI

“…The use of EF-MRI led to a more frequent overstaging for this reader in early tumours, which are in general more difficult to stage using MRI. 21 The current results could not confirm other's observations of an improved T-staging, 19 potentially due to the expansion of the rectum together with compression of the mesorectal fat. This expansion and compression can lead to a closer positioning of the rectum tumour towards surrounding structures, which can hypothetically induce overstaging especially in early tumours.…”

“…Literature is controversial to perform filling of the rectum because of possible overestimation of involvement of the MRF. 9 Ye et al 19 observed a shortened distance of the rectal wall to the MRF, but at the site of the tumour the distance towards the MRF was not reduced. This A frequently used argument propagating for EF is that it aids in detecting and delineating the tumour and consequently could aid in assessment of the pT stage.…”

Stellenwert und qualitative Voraussetzungen der Magnetresonanztomografie für die Therapieplanung beim lokal fortgeschrittenen Rektumkarzinom – Interdisziplinäre Empfehlungen

“…Die Akquisition von hochauflösenden T2-gewichteten Sequenzen in drei Achsentransversal, koronar und sagittal - wird als Routineprotokoll empfohlen und sollte sich an der Tumorachse orientieren [9,12]: [13,14]. Dazu kann bis dato keine allgemeine Empfehlung gegeben werden.…”

Pelvic MRI: Is Endovaginal or Rectal Filling Needed?

“…No rectal filling was conducted before imaging in that study ( 8 ). Another recent study comparing results of pelvic MRI conducted for rectal cancer in 50 patients imaged without and after rectal filling concluded that rectal distension improved visualization of tumors, even though studies were conducted on a 3T MR unit ( 9 ).…”