Rectal cancer MRI: protocols, signs and future perspectives radiologists should consider in everyday clinical practice

Pizzi, Andrea Delli; Basilico, Raffaella; Cianci, Roberta; Seccia, Barbara; Timpani, Mauro; Tavoletta, Alessandra; Caposiena, Daniele; Faricelli, Barbara; Gabrielli, Daniela; Caulo, Massimo

doi:10.1007/s13244-018-0606-5

Cited by 35 publications

(24 citation statements)

References 52 publications

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“…High-field-strength MRI provides fast image acquisition, high spatial resolution, and high signalto-noise ratio, improving the visibility of the rectal wall (25). Ideally, higher field strengths (eg, 1.5 T or 3.0 T) are preferred, with some studies demonstrating similar accuracies for staging for both (26)(27)(28). While 1.5 T is the most widely available and used, 3.0 T may improve spatial resolution, with an increase of the signal-to-noise ratio, and may be preferable to 1.5 T. However, some experts cite greater magnetic susceptibility artifact at 3.0 T, which may occur during DWI, as a potential disadvantage (29,30).…”

Section: Dosmentioning

confidence: 99%

MRI of Rectal Cancer: Tumor Staging, Imaging Techniques, and Management

et al. 2019

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Rectal cancer is prone to local recurrence and systemic metastasis. However, owing to improvements in TNM staging and treatment, including a more widespread use of rectal MRI and increased radiologist awareness of the key rectal cancer TNM staging features, the mortality rate of rectal cancer has been declining over the past few decades in adults over 50 years of age. Currently, rectal MRI plays a key role in the pre-and posttreatment evaluation of rectal cancer, assisting the multidisciplinary team in tailoring the most appropriate treatment option. The benefits achieved with rectal MRI are strictly dependent on obtaining good-quality images, which is important for the characterization of the main anatomic structures and their relationship with the tumor. In primary staging, rectal MRI helps the radiologist (a) describe the tumor location and morphology, (b) provide its T and N categories, (c) detect the presence of extramural vascular invasion, and (d) identify its relationship with surrounding structures, including the sphincter complex and involvement of the mesorectal fascia. These features help diagnose locally advanced rectal tumors (categories T3c-d, T4, N1, and N2), for which neoadjuvant chemoradiotherapy (CRT) is indicated. In restaging after neoadjuvant CRT, in addition to reassessing the features noted during primary staging, rectal MRI can help in the assessment of treatment response, especially with the emergence of nonsurgical approaches such as "watch and wait." © RSNA, 2019 • radiographics.rsna.org

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Section: Dosmentioning

confidence: 99%

MRI of Rectal Cancer: Tumor Staging, Imaging Techniques, and Management

et al. 2019

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“…To overcome this limitation, functional parameters to evaluate tissue viability obtained by position emission tomography, dynamic contrast-enhanced MRI, and diffusion-weighted imaging (DWI) are being assessed. The practice of merging DWI into a standard MRI protocol is increasing because of the ability of DWI to detect and characterize lesions, which enhances its capability in the assessment of the treatment response, 6–10 thus increasing clinical conﬁdence and decreasing false positives. 11,12 DWI assessment may be performed qualitatively or quantitatively with a mono-exponential analysis [apparent diffusion coefficient (ADC) map] or bi-exponential analysis [intravoxel incoherent motion (IVIM) model] or with diffusion kurtosis imaging (DKI) based on a kurtosis model.…”

Section: Introductionmentioning

confidence: 99%

Diffusion kurtosis imaging in patients with locally advanced rectal cancer: current status and future perspectives

et al. 2019

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Morphological magnetic resonance imaging is currently the best imaging technique for local staging in patients with rectal cancer. However, morphological sequences have some limitations, especially after preoperative chemoradiotherapy (pCRT). Diffusion-weighted imaging has been applied to rectal cancer for detection of lesions, characterization of tissue, and evaluation of the response to therapy. In 2005, a non-Gaussian diffusion model called diffusion kurtosis imaging (DKI) was suggested. Several electronic databases were evaluated in the present review. The search included articles published from January 2000 to May 2018. The references of all articles were also evaluated. All titles and abstracts were assessed, and only the studies of DKI in patients with rectal cancer were retained. We identiﬁed 35 potentially relevant references through the electronic search. According to the inclusion and exclusion criteria, we retained five clinical studies that met the inclusion criteria. DKI is a useful tool for assessment of tumor aggressiveness, the nodal status, and the risk of early metastases as well as prediction of the response to pCRT. The results of DKI should be considered in treatment decision-making during the work-up of patients with rectal cancer.

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“…Thanks to their superparamagnetic properties, SPION proved to be an excellent contrast for magnetic resonance imaging (MRI), one of the leading techniques in cancer diagnostics [1,2,3]. Recently, SPION have also gained attention due to their ability to induce magnetic hyperthermia (MHT) [4]. When an external alternating magnetic field of specific frequency is applied, it causes SPION to heat.…”

Section: Introductionmentioning

confidence: 99%

A Hybrid System for Magnetic Hyperthermia and Drug Delivery: SPION Functionalized by Curcumin Conjugate

et al. 2018

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Cancer is among the leading causes of death worldwide, thus there is a constant demand for new solutions, which may increase the effectiveness of anti-cancer therapies. We have designed and successfully obtained a novel, bifunctional, hybrid system composed of colloidally stabilized superparamagnetic iron oxide nanoparticles (SPION) and curcumin containing water-soluble conjugate with potential application in anticancer hyperthermia and as nanocarriers of curcumin. The obtained nanoparticulate system was thoroughly studied in respect to the size, morphology, surface charge, magnetic properties as well as some biological functions. The results revealed that the obtained nanoparticles, ca. 50 nm in diameter, were the agglomerates of primary particles with the magnetic, iron oxide cores of ca. 13 nm, separated by a thin layer of the applied cationic derivative of chitosan. These agglomerates were further coated with a thin layer of the sodium alginate conjugate of curcumin and the presence of both polymers was confirmed using thermogravimetry. The system was also proven to be applicable in magnetic hyperthermia induced by the oscillating magnetic field. A high specific absorption rate (SAR) of 280 [W/g] was registered. The nanoparticles were shown to be effectively uptaken by model cells. They were found also to be nontoxic in the therapeutically relevant concentration in in vitro studies. The obtained results indicate the high application potential of the new hybrid system in combination of magnetic hyperthermia with delivery of curcumin active agent.

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Rectal cancer MRI: protocols, signs and future perspectives radiologists should consider in everyday clinical practice

Cited by 35 publications

References 52 publications

MRI of Rectal Cancer: Tumor Staging, Imaging Techniques, and Management

MRI of Rectal Cancer: Tumor Staging, Imaging Techniques, and Management

Diffusion kurtosis imaging in patients with locally advanced rectal cancer: current status and future perspectives

A Hybrid System for Magnetic Hyperthermia and Drug Delivery: SPION Functionalized by Curcumin Conjugate

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