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

ABSTRACT: Magnetic resonance imaging (MRI) allows to non-invasively evaluate rectal cancer staging and to assess the presence of “prognostic signs” such as the distance from the anorectal junction, the mesorectal fascia infiltration and the extramural vascular invasion. Moreover, MRI plays a crucial role in the assessment of treatment response after chemo-radiation therapy, especially considering the growing interest in the new conservative policy (wait and see, minimally invasive surgery). We present a practical overview regarding the state of the art of the MRI protocol, the main signs that radiologists should consider for their reports during their clinical activity and future perspectives. TEACHING POINTS: • MRI protocol for rectal cancer staging and re-staging. • MRI findings that radiologists should consider for reports during everyday clinical activity. • Perspectives regarding the development of latest technologies.