Preoperative Staging of Rectal Cancer Using Magnetic Resonance Imaging With External Phase-Arrayed Coils

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Abstract
THE PROGNOSIS and treatment of rectal carcinoma depend on the stage at presentation.1,2 Low-lying lesions confined to the rectal wall may be treated by local excision alone.3-5 Lesions that extend beyond the rectal wall have an increased recurrence rate when the mesorectum is inadequately excised6,7 and are best treated through laparotomy. The use of preoperative irradiation may down-stage locally advanced disease8,9 and improve prognosis,10 but to date there are no established criteria to identify the patients who would benefit from this approach. For tumors known to invade adjacent organs, neoadjuvant chemotherapy and radiation therapy have been used to achieve tumor-free margins,11 and in selected cases resection of adjacent pelvic organs, such as the urinary bladder, with the appropriate reconstruction may be required. Accurate preoperative staging is therefore crucial to determine the most appropriate treatment modality.

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