Response Assessment after Neoadjuvant Chemoradiotherapy in Rectal Cancer

Management of locally advanced rectal cancer is complex, and magnetic resonance imaging (MRI) findings play a central role in treatment decisions. While neoadjuvant chemoradiotherapy significantly improved local recurrence rates, newer treatment modalities, such as total neoadjuvant chemotherapy, im...

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Main Authors: Anuradha Chandramohan, Antony Augustine, Sneha Hiriyanna, Shobiga Natarajan, Ajeet A. Selvam, Kurian C. Eapen, Saloni A. Yadav, Joseph Chacko Paul, Aisha Lakhani, Betty Simon, Anu Eapen
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2025-05-01
Series:Journal of Gastrointestinal and Abdominal Radiology
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1802595
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Summary:Management of locally advanced rectal cancer is complex, and magnetic resonance imaging (MRI) findings play a central role in treatment decisions. While neoadjuvant chemoradiotherapy significantly improved local recurrence rates, newer treatment modalities, such as total neoadjuvant chemotherapy, improved distant control. They significantly improved pathological complete response rates, enabling organ preservation in more patients. MRI is the best imaging modality to assess treatment response. MRI aids in assessing operability, predicts surgical outcomes following neoadjuvant treatment, and aids in identifying patients' eligible for organ preservation and their follow-up. In this review, we discuss imaging techniques and interpretation of rectal cancer MRI following neoadjuvant treatment, provide a structured reporting template for response assessment MRI, and detail how imaging findings influence treatment decisions.
ISSN:2581-9178