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Rectal Carcinoma

MRI is the modality of choice for initial staging of rectal carcinoma, providing assessment of lesion size, extension into perirectal fat, proximity to the mesorectal fascia, and lymph nodes. Additionally, MRI of the abdomen may be included to assess for liver metastases.

For individuals requiring radiation and/or chemotherapy before a surgical resection, a repeat MRI can help tailor the surgical approach, or assist in determining  whether a second-line chemo-radiotherapy may be beneficial.

After therapy, MRI is valuable in the setting of suspected recurrence.

Sample Epic Order

bdomen/Pelvis MRI (local staging and liver metastasis evaluation)Pelvis MRI (local staging only)

Download and Print A Request

AttachmentSize
PDF icon Dedicated pelvis MRI order for local staging/restaging.1.08 MB
PDF icon Pelvis MRI for local disease evaluation as well as abdomen MRI for hepatic metastases.1.08 MB

How to place an MRI request on Epic

Examples (click on images)

PET-MRI of rectal carcinoma.PET-MRI can provide accurate local tumor staging as well as assesment of distant disease

References

  1. Iafrate F, et al. Preoperative staging of rectal cancer with MR imaging: correlation with surgical and histopathologic findings. RadioGraphics 2006; 26:701-14. PubMed link
  2. Kaur H, et al. MR imaging for preoperative evaluation of primary rectal cancer: practical considerations. RadioGraphics 2012; 32:389-409. PubMed link
  3. Barbaro B, et al. Restaging locally advanced rectal cancer with MR imaging after chemoradiation therapy. RadioGraphics 2010; 30:699-716. PubMed link