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Response evaluation after neoadjuvant treatment for rectal cancer using modern MR imaging: a pictorial review

In recent years, neoadjuvant chemoradiotherapy (CRT) has become the standard of care for patients with locally advanced rectal cancer. Until recently, patients routinely proceeded to surgical resection after CRT, regardless of the response. Nowadays, treatment is tailored depending on the response t...

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Autores principales: Lambregts, Doenja M. J., Boellaard, Thierry N., Beets-Tan, Regina G. H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375095/
https://www.ncbi.nlm.nih.gov/pubmed/30758688
http://dx.doi.org/10.1186/s13244-019-0706-x
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author Lambregts, Doenja M. J.
Boellaard, Thierry N.
Beets-Tan, Regina G. H.
author_facet Lambregts, Doenja M. J.
Boellaard, Thierry N.
Beets-Tan, Regina G. H.
author_sort Lambregts, Doenja M. J.
collection PubMed
description In recent years, neoadjuvant chemoradiotherapy (CRT) has become the standard of care for patients with locally advanced rectal cancer. Until recently, patients routinely proceeded to surgical resection after CRT, regardless of the response. Nowadays, treatment is tailored depending on the response to chemoradiotherapy. In patients that respond very well to CRT, organ-preserving treatments such as watch-and-wait are increasingly considered as an alternative to surgery. To facilitate such personalized treatment planning, there is now an increased demand for more detailed radiological response evaluation after chemoradiation. MRI is one of the main tools used to assess response, but has difficulties in assessing response within areas of post-radiation fibrosis. Hence, MR sequences such as diffusion-weighted imaging are increasingly adopted in clinical MR protocols to improve the differentiation between tumor and fibrosis. In this pictorial review, we discuss the strengths and weaknesses of modern MR imaging, including functional imaging sequences such as diffusion-weighted MRI, for response evaluation after chemoradiation treatment and provide the main pearls and pitfalls for image interpretation.
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spelling pubmed-63750952019-03-04 Response evaluation after neoadjuvant treatment for rectal cancer using modern MR imaging: a pictorial review Lambregts, Doenja M. J. Boellaard, Thierry N. Beets-Tan, Regina G. H. Insights Imaging Pictorial Review In recent years, neoadjuvant chemoradiotherapy (CRT) has become the standard of care for patients with locally advanced rectal cancer. Until recently, patients routinely proceeded to surgical resection after CRT, regardless of the response. Nowadays, treatment is tailored depending on the response to chemoradiotherapy. In patients that respond very well to CRT, organ-preserving treatments such as watch-and-wait are increasingly considered as an alternative to surgery. To facilitate such personalized treatment planning, there is now an increased demand for more detailed radiological response evaluation after chemoradiation. MRI is one of the main tools used to assess response, but has difficulties in assessing response within areas of post-radiation fibrosis. Hence, MR sequences such as diffusion-weighted imaging are increasingly adopted in clinical MR protocols to improve the differentiation between tumor and fibrosis. In this pictorial review, we discuss the strengths and weaknesses of modern MR imaging, including functional imaging sequences such as diffusion-weighted MRI, for response evaluation after chemoradiation treatment and provide the main pearls and pitfalls for image interpretation. Springer Berlin Heidelberg 2019-02-13 /pmc/articles/PMC6375095/ /pubmed/30758688 http://dx.doi.org/10.1186/s13244-019-0706-x Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Pictorial Review
Lambregts, Doenja M. J.
Boellaard, Thierry N.
Beets-Tan, Regina G. H.
Response evaluation after neoadjuvant treatment for rectal cancer using modern MR imaging: a pictorial review
title Response evaluation after neoadjuvant treatment for rectal cancer using modern MR imaging: a pictorial review
title_full Response evaluation after neoadjuvant treatment for rectal cancer using modern MR imaging: a pictorial review
title_fullStr Response evaluation after neoadjuvant treatment for rectal cancer using modern MR imaging: a pictorial review
title_full_unstemmed Response evaluation after neoadjuvant treatment for rectal cancer using modern MR imaging: a pictorial review
title_short Response evaluation after neoadjuvant treatment for rectal cancer using modern MR imaging: a pictorial review
title_sort response evaluation after neoadjuvant treatment for rectal cancer using modern mr imaging: a pictorial review
topic Pictorial Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375095/
https://www.ncbi.nlm.nih.gov/pubmed/30758688
http://dx.doi.org/10.1186/s13244-019-0706-x
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