Multiparametric MRI of Rectal Cancer for Estimating the Response to Neoadjuvant Therapy and Postoperative As-sessment in Locally Advanced Rectal Cancer

Farahat, Roaa M.; Habba, Mohamed R.; Elserafy, Ahmed F.; Gomaa, Ahmed M.; Noureldin, Radwa A.

doi:10.21608/scumj.2023.305307

Multiparametric MRI of Rectal Cancer for Estimating the Response to Neoadjuvant Therapy and Postoperative As-sessment in Locally Advanced Rectal Cancer

Document Type : Original Article

Authors

¹ Department of Diagnostic Radiology, Faculty of Medicine, Suez Canal University, Egypt

² Surgical Oncology Unit, Department of Surgery, Faculty of Medicine, Suez Canal University, Egypt

10.21608/scumj.2023.305307

Abstract

Background: Conventional MRI gained wide acceptance in pretreatment evaluation of rectal cancer, yet Sensitivity and specificity in evaluating the response to Neoadjuvant therapy and post-operative assessment are less. Due to limitations of the conventional MRI which is based on classical morphological evaluation, the “multiparametric MRI“ was introduced comprising the addition of functional MRI sequences namely diffusion and perfusion to routine MRI. Aim: we aimed to highlight the value of conventional MRI with the addition of functional Technique by diffusion and perfusion analysis in the assessment of response to Neoadjuvant therapy and post-operative follow-up predicting the outcome of the disease. Methods: This study included 29 patients with stage II and III rectal cancer who received neoadjuvant therapy after having their baseline MRI during the period from January 2021 to January 2022. Patients had their MRI (post CRT) within 8 – 10 weeks, and then they underwent surgery in the form of anterior resection with TME or APR. Results: We found that biomarkers of functional MRI have greater potency for predicting response to neoadjuvant therapy in locally advanced rectal cancer when compared to conventional MRI sequences. Five (17.2%) patients showed complete response to neoadjuvant treatment while 8 (27.5%) patients had no response that when projected to the final pathological results gives a sensitivity of nearly 95.2% and specificity of 100%. Conclusion: Multiparametric MRI is a better tool to assess response to neoadjuvant treatment in locally advanced rectal cancer giving the patient good chances regarding tailoring the best surgical options that affect disease control and overall survival.

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