Importance and Qualitative Requirements of Magnetic Resonance Imaging for Therapy Planning in Rectal Cancer - Interdisciplinary Recommendations of AIO, ARO, ACO and the German Radiological Society.

Due to its excellent intrinsic soft tissue contrast, magnetic resonance imaging allows excellent visualization and anatomical separation of therapy-relevant risk structures such as the mesorectal fascia, local lymph nodes, and vascular structures in patients with rectal carcinoma. This makes magnetic resonance imaging (MRI) a valuable evaluation method for further therapeutic stratification. In particular, MRI is indispensable for the decision to refrain from neoadjuvant therapy and to choose a primary surgical approach. In addition to the oncologically generally relevant T-, N-, and M-criteria, two further parameters are included: the extramural vascular infiltration and the circumferential resection margin. Due to the significant impact of MRI on further therapeutic decision-making, standardized MR image quality is considered essential. KEY POINTS::   · Magnetic resonance imaging is a valuable evaluation method for further therapeutic stratification.. · Critical anatomic landmarks for evaluation are circumferential resection margins.. CITATION FORMAT: · Attenberger UI, Clasen S, Ghadimi M et al. Importance and Qualitative Requirements of Magnetic Resonance Imaging for Therapy Planning in Rectal Cancer - Interdisciplinary Recommendations of AIO, ARO, ACO and the German Radiological Society. Fortschr Röntgenstr 2021; 193: 513 - 520.
Competing Interests: Ulrike Attenberger has received a speaker’s honorarium from Siemens Healthyneers. Sebastian Stintzing has received the following Research grants from Merck KGaA, Pierre-Fabre, Servier and Roche; speaker’s fees from AMGEN, Bayer, BMS, ESAI, Lilly, Merck KGaA, MSD, Pierre-Fabre, Roche, Sanofi, Servier, Taiho and Takeda; and consulting services for AMGEN, Bayer, BMS, ESAI, Lilly, Merck KGaA, MSD, Pierre-Fabre, Sanofi, Servier, Taiho, Takeda and Roche. Michael Ghadimi received: Travel expense reimbursements from the MHH Foundation, German Cancer Aid, Elsevier GmbH, German Research Foundation, Johnson & Johnson, Charité Berlin, German Cancer Society, MCI Germany, Bonn Clinic for General Surgery, Tübingen Clinic for Radiooncology, Frankfurt University Hospital Radiation Clinic, Georg Thieme Verlag, Bremerhaven Hospital, Interplan Congress, Meeting & Event Management AG, MCI Germany GmbH, Bremerhaven Reinkenheide Hospital and Boehringer Ingelheim Pharma; Fees from Klinikum Bremerhaven, MCI Deutschland GmbH and Boehringer Ingelheim Pharma.The other authors declare that they have no conflict of interest.
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