Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Interpretation of Rectal MRI after Neoadjuvant Treatment in Patients with Rectal Cancer

수술 전 선행보조치료를 받은 직장암 환자의 직장 자기공명영상의 해석

  • Nieun Seo (Department of Radiology, Severance Hospital, Yonsei University College of Medicine) ;
  • Joon Seok Lim (Department of Radiology, Severance Hospital, Yonsei University College of Medicine)
  • 서니은 (연세대학교 의과대학 영상의학교실) ;
  • 임준석 (연세대학교 의과대학 영상의학교실)
  • Received : 2023.01.19
  • Accepted : 2023.03.14
  • Published : 2023.05.01
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Abstract

MRI is currently the imaging modality of choice to evaluate rectal cancer after neoadjuvant treatment. The purposes of restaging MRI are to assess the resectability of rectal cancer and to decide whether organ preservation strategies can be applied in patients with a complete clinical response. This review article indicates the key MRI features needed to evaluate rectal cancer after neoadjuvant treatment using a systematic approach. Assessment of primary tumor response including MRI findings to predict a complete response is discussed. Additionally, MRI evaluation of the relationship between the primary tumor and adjacent structures, lymph node response, extramural venous invasion, and tumor deposits after neoadjuvant treatment is presented. Knowledge of these imaging features and their clinical relevance may help radiologists provide an accurate and clinically valuable interpretation of restaging rectal MRI.

자기공명영상은 현재 선행보조치료 후 직장암을 평가할 수 있는 가장 우수한 영상검사이다. 선행보조치료 후 시행하는 직장 자기공명영상의 목적은 직장암의 절제가능성을 평가하고 임상적으로 완전관해로 생각되는 환자들에서 장기 보존 전략을 적용할 수 있게 하는 것이다. 이번 종설에서는 선행보조치료 후 자기공명영상에서 평가해야 할 중요한 소견들을 체계적으로 평가하는 방법을 다루고자 한다. 먼저 원발 종양의 치료 반응을 평가하고, 완전관해를 시사하는 영상 소견에 대해 고찰하고자 한다. 또한 선행보조치료 후 원발 종양과 주변 구조물과의 관계, 임파절, extramural venous invasion, tumor deposit의 소견을 다루고자 한다. 이러한 영상 소견 및 임상적 중요성에 대한 지식은 정확하고 임상적으로 의미 있는 판독을 제공하는데 기여할 것이다.

Keywords

Acknowledgement

Medical Illustration & Design (MID), a part of the Medical Research Support Services of Yonsei University College of Medicine, for providing support with medical illustration.

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