Value of Pelvic Magnetic Resonance Imaging in Local Staging of Rectal Cancer

Abstract Background: The prognosis for patients with rectal cancer is closely related to the stage of the disease at the time of diagnosis. Currently, rectal Magnetic Resonance Imaging (MRI) is the most encouraging imaging modality for local staging of rectal cancer. Aim of Sudy: This study aimed to evaluate the role of pelvic MRI in staging of the rectal cancer for management decision. Patients and Methods: This prospective study included 30 patients who proved to have rectal cancer by clinical and histopathological studies. Pelvic MRI was accomplished for all patients according to the following protocol: Sagittal T2WI; Axial T2WI; Axial T 1 SPIR; Axial T 1 WI; and Coronal T2 TSE. T staging and N staging were performed for the lesions. Results: Thirty patients were included in this study, 21 males and 9 females with their ages range between 19 and 80 years (mean=43 years). MRI defined the location of the tumor in the upper third (2 cases), 6 cases at the middle third and in 21 cases at the lower third of the rectum. T staging: No lesions were staged as T1, one case was staged as T2, twenty-three lesions were diagnosed as T3; five cases were diagnosed to have T4 lesion (local infiltration) involving; prostate (4 cases) and infiltrating the skin and penile root in another case. The operative findings confirmed MRI data in those cases. One case was staged as T0 stage following proctoscopic resection of rectal polyp and proved to be rectal carcinoma (villous carcinoma). The sensitivity of MRI was identical to (100%) operative and histopathological assessment in all T stages from (T 1 to T4). N staging: The N stage was interpreted according to the TNM classification, any enlarged node in this study was suspected to be positive for metastatic deposits. Conclusions: Pelvic MRI provides high resolution images of the entire mesorectum allowing for an accurate staging of rectal cancer. It offers multiplannar capabilities with high resolution, non-invasive however it is relatively a costly examination. It is of high value in building up the best therapy strategy for cancer rectum patients.