Advances in MRI-Based Assessment of Rectal Cancer Post-Neoadjuvant Therapy: A Comprehensive Review

Author:

Miranda Joao12ORCID,Causa Andrieu Pamela3ORCID,Nincevic Josip1,Gomes de Farias Lucas de Padua45,Khasawneh Hala6ORCID,Arita Yuki17ORCID,Stanietzky Nir8,Fernandes Maria Clara1ORCID,De Castria Tiago Biachi910ORCID,Horvat Natally1ORCID

Affiliation:

1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA

2. Department of Radiology, University of Sao Paulo, R. Dr. Ovidio Pires de Campos, 75 Cerqueira Cesar, Sao Paulo 05403-010, Brazil

3. Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA

4. Department of Radiology, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 91—Bela Vista, Sao Paulo 01308-050, Brazil

5. Department of Radiology, Allianca Saude, Av. Pres. Juscelino Kubitschek, 1830, Sao Paulo 01308-050, Brazil

6. Department of Radiology, University of Texas Southwestern, 5323 Harry Hines Blvd, Dallas, TX 75390, USA

7. Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan

8. Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

9. Department of Gastrointestinal Oncology, Moffit Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA

10. Morsani College of Medicine, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, USA

Abstract

Rectal cancer presents significant diagnostic and therapeutic challenges, with neoadjuvant therapy playing a pivotal role in improving resectability and patient outcomes. MRI serves as a critical tool in assessing treatment response. However, differentiating viable tumor tissue from therapy-induced changes on MRI remains a complex task. In this comprehensive review, we explore treatment options for rectal cancer based on resectability status, focusing on the role of MRI in guiding therapeutic decisions. We delve into the nuances of MRI-based evaluation of treatment response following neoadjuvant therapy, paying particular attention to emerging techniques like radiomics. Drawing from our insights based on the literature, we provide essential recommendations for post-neoadjuvant therapy management of rectal cancer, all within the context of MRI-based findings.

Funder

National Cancer Institute

RSNA Research & Education Foundation

Publisher

MDPI AG

Subject

General Medicine

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