Update to the structured MRI report for primary staging of rectal cancer : Perspective from the SAR Disease Focused Panel on Rectal and Anal Cancer

Zahra Kassam^{1

2}, Rebecca Lang³, Supreeta Arya⁴, David D B Bates⁵, Kevin J Chang⁶, Tyler J Fraum⁷, Kenneth A Friedman⁸, Jennifer S Golia Pernicka⁵, Marc J Gollub⁵, Mukesh Harisinghani⁹, Gaurav Khatri¹⁰, Elena Korngold¹¹, Chandana Lall¹², Sonia Lee¹³, Michael Magnetta¹⁴, Courtney Moreno¹⁵, Stephanie Nougaret¹⁶, Viktoriya Paroder⁵, Raj M Paspulati¹⁷, Iva Petkovska⁵, Perry J Pickhardt¹⁸, Hiram Shaish¹⁹, Shannon Sheedy²⁰, Martin R Weiser⁵, Lisa Xuan³, David H Kim¹⁸

Affiliations

¹ Western University, London, ON, Canada. Zahra.kassam@sjhc.london.on.ca.
² Department of Medical Imaging, St. Joseph's Hospital, Schulich School of Medicine Western University, 268 Grosvenor Street, London, ON, N6A 4V2, Canada. Zahra.kassam@sjhc.london.on.ca.
³ Western University, London, ON, Canada.
⁴ Tata Memorial Centre, Mumbai, India.
⁵ Memorial Sloan Kettering Cancer Center, New York, NY, USA.
⁶ Boston University, Boston, MA, USA.
⁷ Mallinckrodt Institute of Radiology, St. Louis, MO, USA.
⁸ Cleveland Medical Center, Cleveland, OH, USA.
⁹ Massachusetts General Hospital, Boston, MA, USA.
¹⁰ University of Texas Southwestern, Dallas, TX, USA.
¹¹ Oregon Health & Science University, Portland, OR, USA.
¹² University of Florida-Jacksonville, Jacksonville, FL, USA.
¹³ University of California-Irvine, Irvine, CA, USA.
¹⁴ Northwestern University, Evanston, IL, USA.
¹⁵ Emory University School of Medicine, Atlanta, GA, USA.
¹⁶ Montpellier Cancer Institute, Montpellier University, Montpellier, France.
¹⁷ Case Western Reserve University, Cleveland, OH, USA.
¹⁸ University of Wisconsin, Madison, WI, USA.
¹⁹ Columbia University, New York, NY, USA.
²⁰ Mayo Clinic Rochester, Rochester, MN, USA.

PMID: 35881198
DOI: 10.1007/s00261-022-03612-3

Update to the structured MRI report for primary staging of rectal cancer : Perspective from the SAR Disease Focused Panel on Rectal and Anal Cancer

Zahra Kassam et al. Abdom Radiol (NY). 2022 Oct.

. 2022 Oct;47(10):3364-3374.

doi: 10.1007/s00261-022-03612-3. Epub 2022 Jul 26.

Authors

Affiliations

¹ Western University, London, ON, Canada. Zahra.kassam@sjhc.london.on.ca.
² Department of Medical Imaging, St. Joseph's Hospital, Schulich School of Medicine Western University, 268 Grosvenor Street, London, ON, N6A 4V2, Canada. Zahra.kassam@sjhc.london.on.ca.
³ Western University, London, ON, Canada.
⁴ Tata Memorial Centre, Mumbai, India.
⁵ Memorial Sloan Kettering Cancer Center, New York, NY, USA.
⁶ Boston University, Boston, MA, USA.
⁷ Mallinckrodt Institute of Radiology, St. Louis, MO, USA.
⁸ Cleveland Medical Center, Cleveland, OH, USA.
⁹ Massachusetts General Hospital, Boston, MA, USA.
¹⁰ University of Texas Southwestern, Dallas, TX, USA.
¹¹ Oregon Health & Science University, Portland, OR, USA.
¹² University of Florida-Jacksonville, Jacksonville, FL, USA.
¹³ University of California-Irvine, Irvine, CA, USA.
¹⁴ Northwestern University, Evanston, IL, USA.
¹⁵ Emory University School of Medicine, Atlanta, GA, USA.
¹⁶ Montpellier Cancer Institute, Montpellier University, Montpellier, France.
¹⁷ Case Western Reserve University, Cleveland, OH, USA.
¹⁸ University of Wisconsin, Madison, WI, USA.
¹⁹ Columbia University, New York, NY, USA.
²⁰ Mayo Clinic Rochester, Rochester, MN, USA.

PMID: 35881198
DOI: 10.1007/s00261-022-03612-3

Abstract

Objective: To review existing structured MRI reports for primary staging of rectal cancer and create a new, freely available structured report based on multidisciplinary expert opinion and literature review.

Methods: Twenty abdominal imaging experts from the Society of Abdominal Radiology (SAR)'s Disease Focused Panel (DFP) on Rectal and Anal Cancer completed a questionnaire and participated in a subsequent consensus meeting based on the RAND-UCLA Appropriateness Method. Twenty-two items were classified via a group survey as "appropriate" or "inappropriate" (defined by ≥ 70% consensus), or "needs group discussion" (defined by < 70% consensus). Certain items were also discussed with multidisciplinary team members from colorectal surgery, oncology and pathology.

Results: After completion of the questionnaire, 16 (72%) items required further discussion (< 70% consensus). Following group discussion, consensus was achieved for 21 (95%) of the items. Based on the consensus meeting, a revised structured report was developed. The most significant modifications included (1) Exclusion of the T2/early T3 category; (2) Replacement of the term "circumferential resection margin (CRM)" with "mesorectal fascia (MRF)"; (3) A revised definition of "mucinous content"; (4) Creation of two distinct categories for suspicious lymph nodes (LNs) and tumor deposits; and (5) Classification of suspicious extra-mesorectal LNs by anatomic location.

Conclusion: The SAR DFP on Rectal and Anal Cancer recommends using this newly updated reporting template for primary MRI staging of rectal cancer.

Keywords: MRI; MRI rectum; Rectal cancer; Synoptic reporting.

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References

1. Siegel, R.L., et al., Colorectal cancer statistics, 2020. CA Cancer J Clin, 2020. 70(3): p. 145–164. - DOI
1. Keller, D.S., et al., The multidisciplinary management of rectal cancer. Nat Rev Gastroenterol Hepatol, 2020. 17(7): p. 414–429. - DOI
1. Horvat, N., et al., MRI of Rectal Cancer: Tumor Staging, Imaging Techniques, and Management. Radiographics, 2019. 39(2): p. 367–387. - DOI
1. Brown, P.J., et al., Standardised reports with a template format are superior to free text reports: the case for rectal cancer reporting in clinical practice. Eur Radiol, 2019. 29(9): p. 5121–5128. - DOI
1. Beets-Tan, R.G.H., et al., Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol, 2018. 28(4): p. 1465–1475. - DOI

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Update to the structured MRI report for primary staging of rectal cancer : Perspective from the SAR Disease Focused Panel on Rectal and Anal Cancer

Affiliations

Update to the structured MRI report for primary staging of rectal cancer : Perspective from the SAR Disease Focused Panel on Rectal and Anal Cancer

Authors

Affiliations

Abstract

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous