MRI restaging of rectal cancer: The RAC (Response–Anal canal–CRM) analysis joint consensus guidelines of the GRERCAR and GRECCAR groups - 17/03/23
The evaluation of tumor response in rectal cancer is a challenge for the radiologist.
The main features to evaluate can be summarized through the “RAC assessment: Response–Anal canal– Circumferential resection margin”.
The combination of functional and morphological tumor features on MRI helps assess rectal tumor response to neoadjuvant therapy.
After a near complete tumor response on MRI, another MRI evaluation at six to ten weeks is recommended to potentially propose a watch and wait approach.
To develop guidelines by international experts to standardize data acquisition, image interpretation, and reporting in rectal cancer restaging with magnetic resonance imaging (MRI).
Materials and methods
Evidence-based data and experts’ opinions were combined using the RAND-UCLA Appropriateness Method to attain consensus guidelines. Experts provided recommendations for reporting template and protocol for data acquisition were collected; responses were analysed and classified as “RECOMMENDED” versus “NOT RECOMMENDED” (if ≥ 80% consensus among experts) or uncertain (if < 80% consensus among experts).
Consensus regarding patient preparation, MRI sequences, staging and reporting was attained using the RAND-UCLA Appropriateness Method. A consensus was reached for each reporting template item among the experts. Tailored MRI protocol and standardized report were proposed.
These consensus recommendations should be used as a guide for rectal cancer restaging with MRI.Le texte complet de cet article est disponible en PDF.
Keywords : Magnetic resonance imaging, Neoadjuvant therapy, Rectal neoplasms, Re-staging, “Watch-and-wait”
Abbreviations : ADC, CRM, ECRT, DWI, EMVI, ESGAR, FOV, GRERCAR group, GRECCAR group, LARC, MRF, MRI, NAT, T2W, TME, TNM, mrTRG
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