Multiparametric MRI in the assessment of the response of locally advanced rectal cancer to neoadjuvant chemoradiotherapy

Abstract

Background Recently, neoadjuvant chemoradiotherapy (CRT), accompanied by curative resection, is the usual therapy for individuals with locally advanced rectal cancer. Rectal MRI is essential for local staging and therapeutic planning in rectal cancer. Adding multiparametric MRI to routine MRI rectal protocol could improve MRI results in the assessment of the response of rectal cancer to the therapy. Aim Our study’s goal was to evaluate the impact of multiparametric MRI, including diffusion-weighted image and dynamic-contrast enhancement, in the evaluation of the response of locally advanced rectal cancer to neoadjuvant CRT. Patients and methods The study was a prospective work that was carried out on 120 patients (52 males and 68 females) aged35–65 years old, with a mean age of 51.73, who were referred from the Oncology Department to the Radiodiagnosis Department throughout a period extending from January 2023 to April 2024. Conventional and functional MRI, including diffusion-weighted image, apparent diffusion coefficient, and dynamic-contrast enhancement were used in the staging of rectal cancer and restaging after CRT then results were compared with pathological results after tumor resection. Results Multiparametric MRI gives the best result with (100%) specificity, 93.3% sensitivity, and 96.6% accuracy in rectal cancer staging and assessment of response to treatment. Conclusion Multiparametric functional MRI is superior to conventional MRI in evaluating the effectiveness of neoadjuvant treatment in locally advanced rectal cancer, enhancing the patient’s chances of selecting the optimal surgical options for disease control and survival.