Radiological imaging of rectal cancer
Keywords:Colorectal cancer, TRUS, MSCT, MRI, Staging
AbstractThis article discusses the possibilities of diagnosing abdominal imagingin patients with rectal cancer, detecting lesions and assessing thestage of the lesions, in order to select the appropriate therapy. Beforethe introduction of imaging technologies, the diagnosis of colorectalpathology was based on conventional methods of inspecting intestineswith a barium enema, with either a single or double contrast bariumenema. Following the development of endoscopic methods and thewide use of colonoscopy, colonoscopy became the method of choicefor diagnosing colorectal diseases. The improvement of ComputerizedTomography (CT) and Magnetic Resonance Imaging (MRI), gave usnew possibilities for diagnosing colorectal cancer. For rectal cancer,trans-rectal US (TRUS) or endo-anal US (EAUS) have a significantrole. For staging rectal cancer, the Multi Slice Computed Tomography(MSCT) is not the method of choice, but Magnetic Resonance Imaging(MRI) is preferred when it comes to monitoring the rectum. Therole of the MRI in the T staging of rectal cancer is crucial in preoperativeassessment of: thickness – the width of the tumor, the extramuralinvasion, the circumference of resection margin (CRM), andthe assessment of the inclusion of mesorectal fascia. For successful executionof surgical techniques, good diagnostic imaging of the canceris necessary in order to have a low level of recurrence. According tomedical studies, the sensitivity of FDG-PET in diagnosing metastaticnodals is low, but for now it is not recommended in routine diagnosisof metastatic colorectal carcinoma.
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