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Advances in clinical and MRI research on lymph node metastasis in rectal cancer
LI Diliang  WAN Lijuan  ZHANG Hongmei 

Cite this article as: LI D L, WAN L J, ZHANG H M. Advances in clinical and MRI research on lymph node metastasis in rectal cancer[J]. Chin J Magn Reson Imaging, 2025, 16(7): 185-191. DOI:10.12015/issn.1674-8034.2025.07.030.


[Abstract] Rectal cancer is one of the most common malignant tumors in China, with both its incidence and mortality rates demonstrating a consistent upward trend in recent years. Lymph node metastasis (LNM), as one of the primary metastatic pathways in rectal cancer, is closely associated with disease staging and patient prognosis. Therefore, accurate assessment of lymph node status is critical for guiding clinical management. The current National Comprehensive Cancer Network guidelines recommend MRI for assessing lymph node status in patients with rectal cancer. However, the diagnostic accuracy of conventional MRI morphological features in identifying LNM remains suboptimal and insufficient to meet clinical demands for precision diagnosis and treatment of rectal cancer. Emerging functional MRI techniques and artificial intelligence demonstrate considerable potential in enhancing predictive capabilities for lymph node evaluation, yet a comprehensive review of recent advances in these fields is still lacking. This review systematically examines the metastatic pathways of lymph nodes, conventional and functional MRI techniques, and artificial intelligence applications in lymph node assessment in rectal cancer. It aims to provide readers with insights into current assessment approaches and future directions. We suggest that future studies should prioritize the discovery of novel morphological biomarkers, refinement of functional MRI techniques and artificial intelligence algorithms, standardization of imaging protocols and diagnostic models, and validation through multi-center studies with large-scale rectal cancer MRI databases. These advancements may accelerate the clinical translation of diagnostic tools, ultimately aiding clinicians in achieving precise diagnosis of LNM and tailoring personalized therapeutic strategies for rectal cancer patients.
[Keywords] rectal cancer；lymph node metastasis；magnetic resonance imaging；clinical management；imaging research

LI Diliang   WAN Lijuan   ZHANG Hongmei*  

Department of Diagnostic Radiology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

Corresponding author: ZHANG H M, E-mail: 13581968865@163.com

Conflicts of interest   None.

Received  2025-04-03
Accepted  2025-06-05
DOI: 10.12015/issn.1674-8034.2025.07.030
Cite this article as: LI D L, WAN L J, ZHANG H M. Advances in clinical and MRI research on lymph node metastasis in rectal cancer[J]. Chin J Magn Reson Imaging, 2025, 16(7): 185-191. DOI:10.12015/issn.1674-8034.2025.07.030.

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