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Review
. 2021 May;193(5):513-520.
doi: 10.1055/a-1299-1807. Epub 2020 Dec 16.

Importance and Qualitative Requirements of Magnetic Resonance Imaging for Therapy Planning in Rectal Cancer - Interdisciplinary Recommendations of AIO, ARO, ACO and the German Radiological Society

[Article in English, German]
Ulrike Irmgard Attenberger  1 , Stephan Clasen  2 , Michael Ghadimi  3 , Ulrich Grosse  4 , Gerald Antoch  5 , Andreas G Schreyer  6 , Johannes Wessling  7 , Daniel Hausmann  8 , Pompiliu Piso  9 , Verena Plodeck  10 , Sebastian Stintzing  11 , Claus Michael Rödel  12 , Ralf Dieter Hofheinz  13
Affiliations
Free article
Review

Importance and Qualitative Requirements of Magnetic Resonance Imaging for Therapy Planning in Rectal Cancer - Interdisciplinary Recommendations of AIO, ARO, ACO and the German Radiological Society

[Article in English, German]
Ulrike Irmgard Attenberger et al. Rofo. 2021 May.
Free article

Abstract
in English, German

Due to its excellent intrinsic soft tissue contrast, magnetic resonance imaging allows excellent visualization and anatomical separation of therapy-relevant risk structures such as the mesorectal fascia, local lymph nodes, and vascular structures in patients with rectal carcinoma. This makes magnetic resonance imaging (MRI) a valuable evaluation method for further therapeutic stratification. In particular, MRI is indispensable for the decision to refrain from neoadjuvant therapy and to choose a primary surgical approach. In addition to the oncologically generally relevant T-, N-, and M-criteria, two further parameters are included: the extramural vascular infiltration and the circumferential resection margin. Due to the significant impact of MRI on further therapeutic decision-making, standardized MR image quality is considered essential. KEY POINTS:: · Magnetic resonance imaging is a valuable evaluation method for further therapeutic stratification.. · Critical anatomic landmarks for evaluation are circumferential resection margins.. CITATION FORMAT: · Attenberger UI, Clasen S, Ghadimi M et al. Importance and Qualitative Requirements of Magnetic Resonance Imaging for Therapy Planning in Rectal Cancer - Interdisciplinary Recommendations of AIO, ARO, ACO and the German Radiological Society. Fortschr Röntgenstr 2021; 193: 513 - 520.

Die Magnetresonanztomografie (MRT) erlaubt aufgrund ihres ausgezeichneten intrinsischen Weichteilkontrastes bei Patienten mit Rektumkarzinom eine hervorragende Darstellung und anatomische Separation therapierelevanter Risikostrukturen wie der mesorektalen Faszie, lokaler Lymphknoten und benachbarter Organe. Dies macht die MRT zu einer wertvollen Bewertungsmethode für die therapeutische Stratifizierung. Insbesondere ist die MRT unverzichtbar für die Entscheidung für den Verzicht auf eine neoadjuvante Therapie und die Wahl eines primär operativen Vorgehens. Neben den onkologisch allgemein relevanten T-, N- und M-Kriterien finden 2 weitere Parameter Eingang: die extramurale Gefäßinfiltration und der zirkumferenzielle Resektionsrand. Aufgrund des wesentlichen Einflusses des MRTs auf die therapeutische Entscheidungsfindung ist eine flächendeckende, standardisierte Bildqualität essenziell. KERNAUSSAGEN:: · Die MRT ist eine wertvolle Bewertungsmethode für die weitere therapeutische Stratifizierung des Rektumkarzinoms.. · Wesentliche Kriterien für die therapeutische Stratifizierung sind: mesorektale Faszie (MRF), Lymphknotensituation, extramurale Gefäßinfiltration.. ZITIERWEISE: · Attenberger UI, Clasen S, Ghadimi M et al. Importance and Qualitative Requirements of Magnetic Resonance Imaging for Therapy Planning in Rectal Cancer – Interdisciplinary Recommendations of AIO, ARO, ACO and the German Radiological Society. Fortschr Röntgenstr 2021; 193: 513 – 520.

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Conflict of interest statement

Ulrike Attenberger has received a speaker’s honorarium from Siemens Healthyneers. Sebastian Stintzing has received the following Research grants from Merck KGaA, Pierre-Fabre, Servier and Roche; speaker’s fees from AMGEN, Bayer, BMS, ESAI, Lilly, Merck KGaA, MSD, Pierre-Fabre, Roche, Sanofi, Servier, Taiho and Takeda; and consulting services for AMGEN, Bayer, BMS, ESAI, Lilly, Merck KGaA, MSD, Pierre-Fabre, Sanofi, Servier, Taiho, Takeda and Roche. Michael Ghadimi received: Travel expense reimbursements from the MHH Foundation, German Cancer Aid, Elsevier GmbH, German Research Foundation, Johnson & Johnson, Charité Berlin, German Cancer Society, MCI Germany, Bonn Clinic for General Surgery, Tübingen Clinic for Radiooncology, Frankfurt University Hospital Radiation Clinic, Georg Thieme Verlag, Bremerhaven Hospital, Interplan Congress, Meeting & Event Management AG, MCI Germany GmbH, Bremerhaven Reinkenheide Hospital and Boehringer Ingelheim Pharma; Fees from Klinikum Bremerhaven, MCI Deutschland GmbH and Boehringer Ingelheim Pharma.The other authors declare that they have no conflict of interest.

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