Share：
Share this content in WeChat
X
[Chinese][PDF]4909
• Review •
Research progress of multimodal magnetic resonance imaging in evaluating preoperative staging, restaging after chemoradiotherapy and efficacy of chemoradiotherapy in rectal cancer
GUO Xiaolin  XUE Liangyuan  TIAN Chunmei  DONG Lijie  CHEN Liang  ZHANG Lin 

GUO X L, XUE L Y, TIAN C M, et al. Research progress of multimodal magnetic resonance imaging in evaluating preoperative staging, restaging after chemoradiotherapy and efficacy of chemoradiotherapy in rectal cancer[J]. Chin J Magn Reson Imaging, 2023, 14(9): 181-185. DOI:10.12015/issn.1674-8034.2023.09.033.


[Abstract] Rectal cancer (RC) is a malignant tumor with high incidence in China and even in the world. In recent years, the application of conventional MRI and functional MRI in RC has developed rapidly. This paper summarized domestic and foreign literatures on high-resolution MRI, dynamic contrast enhanced MRI, diffuse-weighted imaging, intravoxel incoherent motion MRI in evaluating the preoperative staging, restaging after chemoradiation, and the efficacy of chemoradiation in RC, hoping to integrate the advantages and disadvantages of each mode of MRI and provide more reliable imaging basis for clinical diagnosis and treatment.
[Keywords] rectal cancer；magnetic resonance imaging；multimodal magnetic resonance imaging；preoperative staging；restaging after chemoradiotherapy；efficacy of chemoradiotherapy

GUO Xiaolin1   XUE Liangyuan1   TIAN Chunmei2   DONG Lijie1   CHEN Liang1   ZHANG Lin1*  

1 Department of Radiology, Binzhou Medical University Hospital, Binzhou 256603, China

2 Department of Pediatrics, Binzhou Medical University Hospital, Binzhou 256603, China

Corresponding author: Zhang L, E-mail: zhanglin730101@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Graduate Teaching Case Base Construction Project of Binzhou Medical College (No. BYYJSALK2021007).
Received  2023-03-22
Accepted  2023-08-04
DOI: 10.12015/issn.1674-8034.2023.09.033
GUO X L, XUE L Y, TIAN C M, et al. Research progress of multimodal magnetic resonance imaging in evaluating preoperative staging, restaging after chemoradiotherapy and efficacy of chemoradiotherapy in rectal cancer[J]. Chin J Magn Reson Imaging, 2023, 14(9): 181-185. DOI:10.12015/issn.1674-8034.2023.09.033.

[1]
SIEGEL R L, MILLER K D, GODING SAUER A, et al. Colorectal cancer statistics, 2020[J]. CA, 2020, 70(3): 145-164. DOI: 10.3322/caac.21601.
[2]
SUNG H, FERLAY J, SIEGEL R L, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660.
[3]
ZHOU X, HU M, LI Z S, et al. Colorectal cancer in the world and China in 2020: an analysis of epidemic status[J]. Acad J Nav Med Univ, 2022, 43(12): 1356-1364. DOI: 10.16781/j.CN31-2187/R.20220593.
[4]
XU L P, ZHANG C, ZHANG Z Y, et al. Value of 3Tesla MRI in the preoperative staging of mid-low rectal cancer and its impact on clinical strategies[J/OL]. Asia Pac J Clin Oncol, 2020, 16(5): e216-e222 [2023-03-21]. https://onlinelibrary.wiley.com/doi/10.1111/ajco.13368. DOI: 10.1111/ajco.13368.
[5]
OPARA C O, KHAN F Y, KABIRAJ D G, et al. The value of magnetic resonance imaging and endorectal ultrasound for the accurate preoperative T-staging of rectal cancer[J/OL]. Cureus, 2022, 14(10): e30499 [2023-03-21]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9674932/. DOI: 10.7759/cureus.30499.
[6]
ZHUANG Z X, ZHANG Y, WEI M T, et al. Magnetic resonance imaging evaluation of the accuracy of various lymph node staging criteria in rectal cancer: a systematic review and meta-analysis[J/OL]. Front Oncol, 2021, 11: 709070 [2023-03-21]. https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.709070/full. DOI: 10.3389/fonc.2021.709070.
[7]
OGURA A, KONISHI T, CUNNINGHAM C, et al. Neoadjuvant (chemo)radiotherapy with total mesorectal excision only is not sufficient to prevent lateral local recurrence in enlarged nodes: results of the multicenter lateral node study of patients with low cT3/4 rectal cancer[J]. J Clin Oncol, 2019, 37(1): 33-43. DOI: 10.1200/JCO.18.00032.
[8]
GRÖNE J, LOCH F N, TAUPITZ M, et al. Accuracy of various lymph node staging criteria in rectal cancer with magnetic resonance imaging[J]. J Gastrointest Surg, 2018, 22(1): 146-153. DOI: 10.1007/s11605-017-3568-x.
[9]
CURVO-SEMEDO L. Rectal cancer: staging[J]. Magn Reson Imaging Clin N Am, 2020, 28(1): 105-115. DOI: 10.1016/j.mric.2019.09.003.
[10]
GOLIA PERNICKA J S, BATES D D B, FUQUA J L, et al. Meaningful words in rectal MRI synoptic reports: how "polypoid" may be prognostic[J]. Clin Imaging, 2021, 80: 371-376. DOI: 10.1016/j.clinimag.2021.08.010.
[11]
LI J, ZHOU Y, WANG X X, et al. An MRI-based multi-objective radiomics model predicts lymph node status in patients with rectal cancer[J]. Abdom Radiol (NY), 2021, 46(5): 1816-1824. DOI: 10.1007/s00261-020-02863-2.
[12]
MA X L, SHEN F, JIA Y, et al. MRI-based radiomics of rectal cancer: preoperative assessment of the pathological features[J/OL]. BMC Med Imaging, 2019, 19(1): 86 [2023-03-21]. https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12880-019-0392-7. DOI: 10.1186/s12880-019-0392-7.
[13]
POMERRI F, PUCCIARELLI S, MARETTO I, et al. Prospective assessment of imaging after preoperative chemoradiotherapy for rectal cancer[J]. Surgery, 2011, 149(1): 56-64. DOI: 10.1016/j.surg.2010.03.025.
[14]
MAAS M, DIJKHOFF R A P, BEETS-TAN R. Rectal cancer: assessing response to neoadjuvant therapy[J]. Magn Reson Imaging Clin N Am, 2020, 28(1): 117-126. DOI: 10.1016/j.mric.2019.09.004.
[15]
YOU Y N, HARDIMAN K M, BAFFORD A, et al. The American society of colon and rectal surgeons clinical practice guidelines for the management of rectal cancer[J]. Dis Colon Rectum, 2020, 63(9): 1191-1222. DOI: 10.1097/DCR.0000000000001762.
[16]
FERNANDES M C, GOLLUB M J, BROWN G. The importance of MRI for rectal cancer evaluation[J/OL]. Surg Oncol, 2022, 43: 101739 [2023-03-21]. https://www.sciencedirect.com/science/article/abs/pii/S0960740422000329?via%3Dihub. DOI: 10.1016/j.suronc.2022.101739.
[17]
FELDER S I, FEUERLEIN S, PARSEE A, et al. Endoscopic and MRI response evaluation following neoadjuvant treatment for rectal cancer: a pictorial review with matched MRI, endoscopic, and pathologic examples[J]. Abdom Radiol, 2021, 46(5): 1783-1804. DOI: 10.1007/s00261-020-02827-6.
[18]
BATES D D B, HOMSI M E, CHANG K J, et al. MRI for rectal cancer: staging, mrCRM, EMVI, lymph node staging and post-treatment response[J]. Clin Colorectal Cancer, 2022, 21(1): 10-18. DOI: 10.1016/j.clcc.2021.10.007.
[19]
ZHU J, SHEN F, YUAN Y, et al. The value of MRI radiomics for evaluation of pathological complete response of rectal cancer after neoadjuvant treatment[J]. Radiol Pract, 2022, 37(4): 426-431. DOI: 10.13609/j.cnki.1000-0313.2022.04.003.
[20]
CHEN Z H, XU B H. Analysis of related factors of pathologic complete response following neoadjuvant chemoradiotherapy in rectal cancer patients[J]. Chin J Cancer Prev Treat, 2022, 29(4): 296-301. DOI: 10.16073/j.cnki.cjcpt.2022.04.11.
[21]
ACHILLI P, MAGISTRO C, AZIZ M A ABD EL, et al. Modest agreement between magnetic resonance and pathological tumor regression after neoadjuvant therapy for rectal cancer in the real world[J]. Int J Cancer, 2022, 151(1): 120-127. DOI: 10.1002/ijc.33975.
[22]
NAHAS S C, NAHAS C S R, CAMA G M, et al. Diagnostic performance of magnetic resonance to assess treatment response after neoadjuvant therapy in patients with locally advanced rectal cancer[J]. Abdom Radiol, 2019, 44(11): 3632-3640. DOI: 10.1007/s00261-019-01894-8.
[23]
PETKOVSKA I, TIXIER F, ORTIZ E J, et al. Clinical utility of radiomics at baseline rectal MRI to predict complete response of rectal cancer after chemoradiation therapy[J]. Abdom Radiol, 2020, 45(11): 3608-3617. DOI: 10.1007/s00261-020-02502-w.
[24]
ZHAO L, ZHANG H M, ZHAO X M. Research progress of quantitative magnetic resonance imaging in preoperative evaluation of rectal cancer[J]. Radiol Pract, 2021, 36(10): 1312-1315. DOI: 10.13609/j.cnki.1000-0313.2021.10.022.
[25]
ARMBRUSTER M, D'ANASTASI M, HOLZNER V, et al. Improved detection of a tumorous involvement of the mesorectal fascia and locoregional lymph nodes in locally advanced rectal cancer using DCE-MRI[J]. Int J Colorectal Dis, 2018, 33(7): 901-909. DOI: 10.1007/s00384-018-3083-x.
[26]
YANG X Y, CHEN Y, WEN Z Q, et al. Role of quantitative dynamic contrast-enhanced MRI in evaluating regional lymph nodes with a short-axis diameter of less than 5 mm in rectal cancer[J]. AJR Am J Roentgenol, 2019, 212(1): 77-83. DOI: 10.2214/AJR.18.19866.
[27]
LU Q Y, GUAN Z, ZHANG X Y, et al. Contrast-enhanced MRI for T restaging of locally advanced rectal cancer following neoadjuvant chemotherapy and radiation therapy[J]. Radiology, 2022, 305(2): 364-372. DOI: 10.1148/radiol.212905.
[28]
WAN L J, LIU Y, PENG W J, et al. Submucosal enhancing stripe as a contrast material-enhanced MRI-based imaging feature for the differentiation of stage T0-T1 from early T2 rectal cancers[J]. Radiology, 2021, 298(1): 93-101. DOI: 10.1148/radiol.2020201416.
[29]
KIM S H, LEE J M, GUPTA S N, et al. Dynamic contrast-enhanced MRI to evaluate the therapeutic response to neoadjuvant chemoradiation therapy in locally advanced rectal cancer[J]. J Magn Reson Imaging, 2014, 40(3): 730-737. DOI: 10.1002/jmri.24387.
[30]
PETRILLO A, FUSCO R, PETRILLO M, et al. DCE-MRI time-intensity curve visual inspection to assess pathological response after neoadjuvant therapy in locally advanced rectal cancer[J]. Jpn J Radiol, 2018, 36(10): 611-621. DOI: 10.1007/s11604-018-0760-1.
[31]
FUSCO R, GRANATA V, SANSONE M, et al. Validation of the standardized index of shape tool to analyze DCE-MRI data in the assessment of neo-adjuvant therapy in locally advanced rectal cancer[J]. Radiol Med, 2021, 126(8): 1044-1054. DOI: 10.1007/s11547-021-01369-1.
[32]
FORNELL-PEREZ R, PEREZ-ALONSO E, PORCEL-DE-PERALTA G, et al. Primary and post-chemoradiotherapy staging using MRI in rectal cancer: the role of diffusion imaging in the assessment of perirectal infiltration[J]. Abdom Radiol, 2019, 44(11): 3674-3682. DOI: 10.1007/s00261-019-02139-4.
[33]
STIJNS R C H, LEIJTENS J, GRAAF E D, et al. Endoscopy and MRI for restaging early rectal cancer after neoadjuvant treatment[J]. Colorectal Dis, 2023, 25(2): 211-221. DOI: 10.1111/codi.16341.
[34]
NAPOLETANO M, MAZZUCCA D, PROSPERI E, et al. Locally advanced rectal cancer: qualitative and quantitative evaluation of diffusion-weighted magnetic resonance imaging in restaging after neoadjuvant chemo-radiotherapy[J]. Abdom Radiol, 2019, 44(11): 3664-3673. DOI: 10.1007/s00261-019-02012-4.
[35]
LI H, CHEN G W, LIU Y S, et al. Assessment of histologic prognostic factors of resectable rectal cancer: comparison of diagnostic performance using various apparent diffusion coefficient parameters[J/OL]. Sci Rep, 2020, 10(1): 11554 [2023-03-21]. https://www.nature.com/articles/s41598-020-68328-0. DOI: 10.1038/s41598-020-68328-0.
[36]
IAFRATE F, CICCARELLI F, MASCI G M, et al. Predictive role of diffusion-weighted MRI in the assessment of response to total neoadjuvant therapy in locally advanced rectal cancer[J]. Eur Radiol, 2023, 33(2): 854-862. DOI: 10.1007/s00330-022-09086-7.
[37]
SASSEN S, BOOIJ M D, SOSEF M, et al. Locally advanced rectal cancer: is diffusion weighted MRI helpful for the identification of complete responders (ypT0N0) after neoadjuvant chemoradiation therapy?[J]. Eur Radiol, 2013, 23(12): 3440-3449. DOI: 10.1007/s00330-013-2956-1.
[38]
CARUSO D, ZERUNIAN M, SANTIS D D, et al. Magnetic resonance of rectal cancer response to therapy: an image quality comparison between 3.0 and 1.5 Tesla[J/OL]. Biomed Res Int, 2020, 2020: 9842732 [2023-03-21]. https://www.hindawi.com/journals/bmri/2020/9842732/. DOI: 10.1155/2020/9842732.
[39]
TARALLO N, ANGERETTI M G, BRACCHI E, et al. Magnetic resonance imaging in locally advanced rectal cancer: quantitative evaluation of the complete response to neoadjuvant therapy[J/OL]. Pol J Radiol, 2018, 83: e600-e609 [2023-03-21]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6384410/. DOI: 10.5114/pjr.2018.81156.
[40]
LAMBREGTS D M J, DELLI PIZZI A, LAHAYE M J, et al. A pattern-based approach combining tumor morphology on MRI with distinct signal patterns on diffusion-weighted imaging to assess response of rectal tumors after chemoradiotherapy[J]. Dis Colon Rectum, 2018, 61(3): 328-337. DOI: 10.1097/DCR.0000000000000915.
[41]
SCHURINK N W, LAMBREGTS D M J, BEETS-TAN R G H. Diffusion-weighted imaging in rectal cancer: current applications and future perspectives[J/OL]. Br J Radiol, 2019, 92(1096): 20180655 [2023-03-21]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6540856/. DOI: 10.1259/bjr.20180655.
[42]
LAMBREGTS D M J, BOELLAARD T N, BEETS-TAN R G H. Response evaluation after neoadjuvant treatment for rectal cancer using modern MR imaging: a pictorial review[J/OL]. Insights Imaging, 2019, 10(1): 15 [2023-03-21]. https://insightsimaging.springeropen.com/articles/10.1186/s13244-019-0706-x. DOI: 10.1186/s13244-019-0706-x.
[43]
HORVAT N, HOPE T A, PICKHARDT P J, et al. Mucinous rectal cancer: concepts and imaging challenges[J]. Abdom Radiol, 2019, 44(11): 3569-3580. DOI: 10.1007/s00261-019-02019-x.
[44]
LU B L, YANG X Y, XIAO X J, et al. Intravoxel incoherent motion diffusion-weighted imaging of primary rectal carcinoma: correlation with histopathology[J]. Med Sci Monit, 2018, 24: 2429-2436. DOI: 10.12659/msm.908574.
[45]
GENG Z J, ZHANG Y F, YIN S H, et al. Preoperatively grading rectal cancer with the combination of intravoxel incoherent motions imaging and diffusion kurtosis imaging[J/OL]. Contrast Media Mol Imaging, 2020, 2020: 2164509 [2023-03-21]. https://www.hindawi.com/journals/cmmi/2020/2164509/. DOI: 10.1155/2020/2164509.
[46]
LI M, XU X D, XIA K J, et al. Comparison of diagnostic performance between perfusion-related intravoxel incoherent motion DWI and dynamic contrast-enhanced MRI in rectal cancer[J/OL]. Comput Math Methods Med, 2021, 2021: 5095940 [2023-03-21]. https://www.hindawi.com/journals/cmmm/2021/5095940/. DOI: 10.1155/2021/5095940.
[47]
SUN H L, XU Y Y, SONG A P, et al. Intravoxel incoherent motion MRI of rectal cancer: correlation of diffusion and perfusion characteristics with prognostic tumor markers[J/OL]. AJR Am J Roentgenol, 2018, 210(4): W139-W147 [2023-03-21]. https://www.ajronline.org/doi/10.2214/AJR.17.18342. DOI: 10.2214/AJR.17.18342.
[48]
LIU L H, ZHOU G F, RAO S X, et al. Early changes in intravoxel incoherent motion MRI parameters can potentially predict response to chemoradiotherapy in rectal cancer: an animal study[J]. Magn Reson Imaging, 2021, 78: 52-57. DOI: 10.1016/j.mri.2021.02.007.
[49]
HU H B, JIANG H J, WANG S, et al. 3.0 T MRI IVIM-DWI for predicting the efficacy of neoadjuvant chemoradiation for locally advanced rectal cancer[J]. Abdom Radiol (NY), 2021, 46(1): 134-143. DOI: 10.1007/s00261-020-02594-4.
[50]
LI H, YUAN Y, CHEN X L, et al. Value of intravoxel incoherent motion for assessment of lymph node status and tumor response after chemoradiation therapy in locally advanced rectal cancer[J/OL]. Eur J Radiol, 2022, 146: 110106 [2023-03-21]. https://www.ejradiology.com/article/S0720-048X(21)00587-8/fulltext. DOI: 10.1016/j.ejrad.2021.110106.
[51]
YANG L Q, XIA C C, ZHAO J, et al. The value of intravoxel incoherent motion and diffusion kurtosis imaging in the assessment of tumor regression grade and T stages after neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer[J/OL]. Eur J Radiol, 2021, 136: 109504 [2023-03-21]. https://www.ejradiology.com/article/S0720-048X(20)30694-X/fulltext. DOI: 10.1016/j.ejrad.2020.109504.
[52]
DING X, SUN D Q, GUO Q C, et al. The value of diffusion kurtosis imaging and intravoxel incoherent motion quantitative parameters in predicting synchronous distant metastasis of rectal cancer[J/OL]. BMC Cancer, 2022, 22(1): 920 [2023-03-21]. https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-10022-7. DOI: 10.1186/s12885-022-10022-7.
[53]
XU Q Y, XU Y Y, SUN H L, et al. Quantitative intravoxel incoherent motion parameters derived from whole-tumor volume for assessing pathological complete response to neoadjuvant chemotherapy in locally advanced rectal cancer[J]. J Magn Reson Imaging, 2018, 48(1): 248-258. DOI: 10.1002/jmri.25931.
[54]
LIANG C Y, CHEN M D, ZHAO X X, et al. Multiple mathematical models of diffusion-weighted magnetic resonance imaging combined with prognostic factors for assessing the response to neoadjuvant chemotherapy and radiation therapy in locally advanced rectal cancer[J]. Eur J Radiol, 2019, 110: 249-255. DOI: 10.1016/j.ejrad.2018.12.005.
[55]
LIU S Y, WEN L, HOU J, et al. Predicting the pathological response to chemoradiotherapy of non-mucinous rectal cancer using pretreatment texture features based on intravoxel incoherent motion diffusion-weighted imaging[J]. Abdom Radiol, 2019, 44(8): 2689-2698. DOI: 10.1007/s00261-019-02032-0.

PREV Application progress of MRI based artificial intelligence in rectal cancer
NEXT Advances in deep learning and Radiomics for precision diagnosis and treatment of bladder cancer
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn