Baseline MR Staging of Rectal Cancer: A Practical Approach

As therapeutic options to treat rectal cancers have advanced over the last several decades, MRI has become the standard of care for baseline local tumor and nodal staging of rectal cancers. An understanding of the technique, anatomy, tumor appearance, and elements of staging on MRI is essential to provide prognostic information and to guide neoadjuvant che-moradiation and surgical treatment. We provide a framework for imaging the rectum on MRI followed by a practical case-based approach to interpretation of pre-treatment MRI of the rectum in evaluation of rectal cancers, with examples and illustrations of the range of local tumor (T) stage and nodal (N) disease involvement. This approach can be paired with stan-dardized reporting templates to support clear, accurate and clinically relevant imaging assessment of rectal cancers. Semin Roentgenology 56:164-176 (c) 2020 Published by Elsevier Inc.

Automated summary

MRI has become the standard for baseline local tumor and nodal staging of rectal cancers, providing essential prognostic information and guiding treatment. A framework for imaging the rectum on MRI and interpreting pre-treatment MRI evaluations of rectal cancers is provided, which can be paired with standardized reporting templates for clear and accurate imaging assessment.