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CC BY 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2025; 08(02): 078-090
DOI: 10.1055/s-0045-1809694
Review Article

Staging of Rectal Cancer: MRI Protocol, Pelvic Anatomy, and Definitions

Dollphy Garg
1   Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Vansha Mehta
1   Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Ajay Gulati
1   Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Satish Subbiah Nagaraj
2   Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Yashwant Sakaray
2   Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Harjeet Singh
3   Department of GI HPB Liver Transplant Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Pankaj Gupta
1   Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations
Financial Disclosure None.
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Abstract

Rectal carcinoma is a prevalent and increasingly diagnosed cancer globally, posing significant mortality and morbidity risks, particularly among younger individuals. Prognosis hinges on several factors, such as site of involvement (upper rectum vs. lower rectum), tumor extension into surrounding tissues, involvement of critical structures like the mesorectal fascia and vessels, and the presence of distant metastases. Treatment approaches are tailored to the tumor's location and extent. Diagnostic tools including digital rectal examination and various imaging modalities like computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-CT play crucial roles in staging, identifying high-risk patients needing neoadjuvant chemoradiotherapy (CRT), and monitoring treatment response. MRI stands out as the preferred modality for locoregional staging, detecting adverse prognostic indicators, assessing post-CRT changes, and long-term surveillance due to its superior contrast resolution. This review discusses the key concepts in the application of MRI to rectal cancer imaging.

Keywords

anorectal junction - circumferential resection margin - mesorectal fascia - MRI - rectal carcinoma


Publication History

Article published online:
12 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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