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Anatomic Basis of Rectal Cancer Staging: Clarifying Controversies and Misconceptions.
Kaur, Harmeet; Gabriel, Helena; Awiwi, Muhammad O; Maheshwari, Ekta; Lopes Vendrami, Camila; Konishi, Tsuyoshi; Taggart, Melissa W; Magnetta, Michael; Kelahan, Linda C; Lee, Sonia.
Afiliação
  • Kaur H; From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.)
  • Gabriel H; From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.)
  • Awiwi MO; From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.)
  • Maheshwari E; From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.)
  • Lopes Vendrami C; From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.)
  • Konishi T; From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.)
  • Taggart MW; From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.)
  • Magnetta M; From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.)
  • Kelahan LC; From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.)
  • Lee S; From the Departments of Abdominal Imaging (H.K.), Colon and Rectal Surgery (T.K.), and Anatomical Pathology (M.W.T.), University of Texas MD Anderson Cancer Center, PO Box 301402, Unit 1473, Houston, TX 77230-1402; Department of Radiology, Northwestern University, Chicago, Ill (H.G., C.L.V., L.C.K.)
Radiographics ; 44(7): e230203, 2024 Jul.
Article em En | MEDLINE | ID: mdl-38900679
ABSTRACT
Rectal MRI provides a detailed depiction of pelvic anatomy; specifically, the relationship of the tumor to key anatomic structures, including the mesorectal fascia, anterior peritoneal reflection, and sphincter complex. However, anatomic inconsistencies, pitfalls, and confusion exist, which can have a strong impact on interpretation and treatment. These areas of confusion include the definition of the rectum itself, specifically differentiation of the rectum from the anal canal and the sigmoid colon, and delineation of the high versus low rectum. Other areas of confusion include the relative locations of the mesorectal fascia and peritoneum and their significance in staging and treatment, the difference between the mesorectal fascia and circumferential resection margin, involvement of the sphincter complex, and evaluation of lateral pelvic lymph nodes. The impact of these anatomic inconsistencies and sources of confusion is significant, given the importance of MRI in depicting the anatomic relationship of the tumor to critical pelvic structures, to triage surgical resection and neoadjuvant chemoradiotherapy with the goal of minimizing local recurrence. Evolving treatment paradigms also place MRI central in management of rectal cancer. ©RSNA, 2024.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Imageamento por Ressonância Magnética / Estadiamento de Neoplasias Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Imageamento por Ressonância Magnética / Estadiamento de Neoplasias Idioma: En Ano de publicação: 2024 Tipo de documento: Article