MR imaging for rectal cancer staging: current concepts and controversies

Magnetic Resonance Imaging (MRI) plays a key role in the diagnostic workup and therapeutic management of rectal cancer. Despite the increased availability of staging guides and reporting templates, there are still several challenges that can lead to uncertainties and variations in the radiological reporting of rectal cancer. These include difficulties in applying clinical-oncologic guidelines (such as the TNM staging manual) to a radiological setting, and the fact that rectal cancer staging requires in depth knowledge of rectal and pelvic image anatomy. Moreover, novel staging concepts have recently been introduced into clinical guidelines that require time and practice to be successfully adopted by radiologists. This thesis addressed these issues and investigated how well novel staging concepts in rectal cancer have been adopted into a radiological routine, how they may impact rectal cancer management, and what are the main pitfalls that remain.