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AIM: To describe the post-chemoradiotherapy magnetic resonance imaging (MRI) features of locally advanced rectal carcinoma (LARC) in which there has been a complete histopathological response to neoadjuvant chemoradiotherapy (CRT). MATERIALS AND METHODS: This retrospective cohort study was performed between January 2005 and November 2009 at a regional cancer centre. Consecutive patients with LARC and a histopathological complete response to long-course CRT were identified. Pre- and post-treatment MRI images were reviewed using a proforma for predefined features and response criteria. ymrT0 was defined as the absence of residual abnormality on MRI. RESULTS: Twenty patients were included in the study. Seven (35%) ypT0 tumours were ymrT0. All 13 ypT0 tumours not achieving ymrT0 appearances had a good radiological response, with at least 65% tumour reduction. The appearances were heterogeneous: in 11/13 patients the tumour was replaced by a region of at least 50% low signal on MRI, with 8/13 having ≥80% low signal, and 3/13 with 100% low signal. CONCLUSION: MRI may be useful in identifying a complete histopathological response. However, the MRI appearances of ypT0 tumours are heterogeneous and conventional MRI complete response criteria will not detect the majority of patients with a complete histopathological response.

Original publication

DOI

10.1016/j.crad.2011.11.004

Type

Journal article

Journal

Clin Radiol

Publication Date

06/2012

Volume

67

Pages

546 - 552

Keywords

Adult, Aged, Aged, 80 and over, Chemoradiotherapy, Cohort Studies, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neoadjuvant Therapy, Observer Variation, Rectal Neoplasms, Remission Induction, Retrospective Studies, Treatment Outcome