SAR user guide to the rectal MR synoptic report (primary staging)

Kassam, Zahra; Lang, R.; Bates, ‬David D. B.; Chang, Kevin J.; Fraum, Tyler J.; Friedman, Kenneth; Pernicka, Jennifer S. Golia; Gollub, Marc J.; Harisinghani, Mukesh G.; Khatri, Gaurav; Lall, Chandana; Lee, S; Magnetta, Michael J.; Nougaret, Stéphanie; Paspulati, Raj Mohan; Paroder, Viktoriya; Shaish, Hiram; Kim, David H.; Nepal, Pankaj; Lalani, Tasneem K.; Homsi, Maria El; Wasnik, Ashish P.; Maheshwari, Ekta

doi:10.1007/s00261-022-03578-2

Cited by 12 publications

(8 citation statements)

References 14 publications

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“…The SAR DFP has not reached a consensus as to whether external anal sphincter involvement should be characterized as T4b. There is clear consensus, however, that in reporting the anal involvement, a specific description of the level of involvement, such as the level of involvement of the internal sphincter, intersphincteric plane, or external sphincter, and the location/length (upper/mid/distal) of the involvement should be communicated to the surgeon, to help select the appropriate surgical option [ 13 ]. In addition, if a tumor is classified as T4b, each structure involved should be clearly specified, and the reporting pattern should be consistent within the institution to avoid confusion [ 1 ].…”

Section: Primary Tumor Stagingmentioning

confidence: 99%

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Rectal cancer lexicon 2023 revised and updated consensus statement from the Society of Abdominal Radiology Colorectal and Anal Cancer Disease-Focused Panel

et al. 2023

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The Society of Abdominal Radiology’s Colorectal and Anal Cancer Disease-Focused Panel (DFP) first published a rectal cancer lexicon paper in 2019. Since that time, the DFP has published revised initial staging and restaging reporting templates, and a new SAR user guide to accompany the rectal MRI synoptic report (primary staging). This lexicon update summarizes interval developments, while conforming to the original lexicon 2019 format. Emphasis is placed on primary staging, treatment response, anatomic terminology, nodal staging, and the utility of specific sequences in the MRI protocol. A discussion of primary tumor staging reviews updates on tumor morphology and its clinical significance, T1 and T3 subclassifications and their clinical implications, T4a and T4b imaging findings/definitions, terminology updates on the use of MRF over CRM, and the conundrum of the external sphincter. A parallel section on treatment response reviews the clinical significance of near-complete response and introduces the lexicon of “regrowth” versus “recurrence”. A review of relevant anatomy incorporates updated definitions and expert consensus of anatomic landmarks, including the NCCN’s new definition of rectal upper margin and sigmoid take-off. A detailed review of nodal staging is also included, with attention to tumor location relative to the dentate line and locoregional lymph node designation, a new suggested size threshold for lateral lymph nodes and their indications for use, and imaging criteria used to differentiate tumor deposits from lymph nodes. Finally, new treatment terminologies such as organ preservation, TNT, TAMIS and watch-and-wait management are introduced. This 2023 version aims to serve as a concise set of up-to-date recommendations for radiologists, and discusses terminology, classification systems, MRI and clinical staging, and the evolving concepts in diagnosis and treatment of rectal cancer. Graphical abstract

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Section: Primary Tumor Stagingmentioning

confidence: 99%

“…As the SAR DFP baseline template has been updated to use the term MRF rather than circumferential resection margin (CRM), that change to the lexicon has been made accordingly [ 13 , 19 ]. Detailed description of the criteria used to evaluate MRF involvement are specified.…”

Section: Primary Tumor Stagingmentioning

confidence: 99%

Rectal cancer lexicon 2023 revised and updated consensus statement from the Society of Abdominal Radiology Colorectal and Anal Cancer Disease-Focused Panel

et al. 2023

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“…Lymph nodes with intact capsules are not considered involved, as they do not correlate with increased local recurrence rates [ 79 , 80 ]. The SAR DFP template utilizes a three-tiered system for MRF status: “involved” for a distance less than 0.1 cm, “threatened” for a distance of 0.1–0.2 cm, and “clear” for a distance of more than 0.2 cm [ 81 ].…”

Section: Rectal Mri Response Assessmentmentioning

confidence: 99%

“…An additional update concerns N classification, as the SAR DFP recommends using “N+” to indicate abnormal locoregional lymph nodes or tumor deposits on MRI and “N−” to indicate the absence of locoregional nodal disease instead of specifying N0, N1a, N1b, N1c, or N2 categories [ 81 ].…”

Section: Rectal Mri Response Assessmentmentioning

confidence: 99%

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Advances in MRI-Based Assessment of Rectal Cancer Post-Neoadjuvant Therapy: A Comprehensive Review

Miranda,

Causa Andrieu,

Nincevic

et al. 2023

JCM

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Rectal cancer presents significant diagnostic and therapeutic challenges, with neoadjuvant therapy playing a pivotal role in improving resectability and patient outcomes. MRI serves as a critical tool in assessing treatment response. However, differentiating viable tumor tissue from therapy-induced changes on MRI remains a complex task. In this comprehensive review, we explore treatment options for rectal cancer based on resectability status, focusing on the role of MRI in guiding therapeutic decisions. We delve into the nuances of MRI-based evaluation of treatment response following neoadjuvant therapy, paying particular attention to emerging techniques like radiomics. Drawing from our insights based on the literature, we provide essential recommendations for post-neoadjuvant therapy management of rectal cancer, all within the context of MRI-based findings.

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Update on The National Accreditation Program for Rectal Cancer (NAPRC): the radiologist’s role

et al. 2023

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SAR user guide to the rectal MR synoptic report (primary staging)

Cited by 12 publications

References 14 publications

Rectal cancer lexicon 2023 revised and updated consensus statement from the Society of Abdominal Radiology Colorectal and Anal Cancer Disease-Focused Panel

Rectal cancer lexicon 2023 revised and updated consensus statement from the Society of Abdominal Radiology Colorectal and Anal Cancer Disease-Focused Panel

Advances in MRI-Based Assessment of Rectal Cancer Post-Neoadjuvant Therapy: A Comprehensive Review

Update on The National Accreditation Program for Rectal Cancer (NAPRC): the radiologist’s role

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