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What the radiologist needs to know about restaging of rectal carcinoma after chemoradiation therapy


The purpose of this exhibit is to describe and compare the high-resolution MRI features of rectal carcinoma after chemoradiation treatment (CRT) and to correlate with the histologic findings after total mesorectal excision (TME).


High resolution T2-W MR imaging (HRMRI) was performed in a 1.5 T unit between January 2013 and February 2014 before and immediately after CRT in the care of 25 patients with locally advanced adenocarcinoma of the rectum. After total mesorectal excision (TME) the piece was cut by the pathologist under the supervision of the radiologist, who indicated areas of residual tumour after neoadjuvant therapy or changes such as fibrosis, oedema, cellular and acellular mucin, desmoplastic reaction and pseudotumour appearance. Thus, initially we did a correlation between the macroscopic and MR imaging. Subsequently, we performed the same correlation but in this case between microscopy and MR imaging. Changes in morphologic and signal intensity features were evaluated with respect to primary tumour and nodal downstaging.


Emerging evidence has shown the prognostic importance of reassessing rectal cancer using HRMRI after completion of CRT. A systematic cooperation between radiologist and pathologist is essential for optimal treatment planning and patient care.

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Correspondence to ME Nazar.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Nazar, M., Grana, F., Alarcon, L. et al. What the radiologist needs to know about restaging of rectal carcinoma after chemoradiation therapy. cancer imaging 14 (Suppl 1), P16 (2014).

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