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Proforma-based reporting in rectal cancer.

Taylor F, Mangat N, Swift IR, Brown G - Cancer Imaging (2010)

Bottom Line: The improvements in outcomes associate with the use of preoperative therapy rather than postoperative treatment means that clinical teams are increasingly reliant on imaging to identify high-risk features of disease to determine treatment plans.In the MERCURY study, a standardised scanning technique and the use of reporting proformas enabled consistently accurate assessment and documentation of the prognostic factors.This is now an essential tool to enable our clinical colleagues to make treatment decisions.

View Article: PubMed Central - PubMed

Affiliation: Mayday University Hospital, Croydon, Surrey, UK.

ABSTRACT
The improvements in outcomes associate with the use of preoperative therapy rather than postoperative treatment means that clinical teams are increasingly reliant on imaging to identify high-risk features of disease to determine treatment plans. For many solid tumours, including rectal cancer, validated techniques have emerged in identifying prognostic factors pre-operatively. In the MERCURY study, a standardised scanning technique and the use of reporting proformas enabled consistently accurate assessment and documentation of the prognostic factors. This is now an essential tool to enable our clinical colleagues to make treatment decisions. In this review, we describe the proforma-based reporting tool that enables a systematic approach to the interpretation of the magnetic resonance images, thereby enabling all the clinically relevant features to be adequately assessed.

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Related in: MedlinePlus

Polypoidal lesions tend to have a smaller invasive front and extend beyond the rectal wall through the stalk.
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Figure 1: Polypoidal lesions tend to have a smaller invasive front and extend beyond the rectal wall through the stalk.

Mentions: As with pathology reporting, it is helpful to the clinical teams to provide a general description of the morphology of the tumour. Rectal cancers can be polypoidal with a low signal intensity stalk that attaches the tumour to the rectal wall or annular with varying degrees of central ulceration. Polypoidal lesions tend to have a smaller invasive front and extend beyond the rectal wall through the stalk (Fig. 1). Annular ulcerating tumours are characterized by a central ulcer/crater with raised rolled edges. They invade at the ulcer crater with either a smooth or more nodular infiltrating border (Fig. 2). The latter is associated with a poorer prognosis and higher rate of metastatic failure [3–8]. It is very rare for rectal tumours to show intramural spread and this would be noteworthy for the surgeon in planning the distal resection margin. Current recommendation allows a 1-cm distal clearance[9–11]. Mucinous tumours are characterized by evidence of high signal intensity pools within the tumour [12] and are associated with a worse prognosis in the rectum. This is thought to be due to the fact that they infiltrate diffusely and unlike annular or polypoidal tumours they may spread intramurally[10,13].Figure 1


Proforma-based reporting in rectal cancer.

Taylor F, Mangat N, Swift IR, Brown G - Cancer Imaging (2010)

Polypoidal lesions tend to have a smaller invasive front and extend beyond the rectal wall through the stalk.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2967144&req=5

Figure 1: Polypoidal lesions tend to have a smaller invasive front and extend beyond the rectal wall through the stalk.
Mentions: As with pathology reporting, it is helpful to the clinical teams to provide a general description of the morphology of the tumour. Rectal cancers can be polypoidal with a low signal intensity stalk that attaches the tumour to the rectal wall or annular with varying degrees of central ulceration. Polypoidal lesions tend to have a smaller invasive front and extend beyond the rectal wall through the stalk (Fig. 1). Annular ulcerating tumours are characterized by a central ulcer/crater with raised rolled edges. They invade at the ulcer crater with either a smooth or more nodular infiltrating border (Fig. 2). The latter is associated with a poorer prognosis and higher rate of metastatic failure [3–8]. It is very rare for rectal tumours to show intramural spread and this would be noteworthy for the surgeon in planning the distal resection margin. Current recommendation allows a 1-cm distal clearance[9–11]. Mucinous tumours are characterized by evidence of high signal intensity pools within the tumour [12] and are associated with a worse prognosis in the rectum. This is thought to be due to the fact that they infiltrate diffusely and unlike annular or polypoidal tumours they may spread intramurally[10,13].Figure 1

Bottom Line: The improvements in outcomes associate with the use of preoperative therapy rather than postoperative treatment means that clinical teams are increasingly reliant on imaging to identify high-risk features of disease to determine treatment plans.In the MERCURY study, a standardised scanning technique and the use of reporting proformas enabled consistently accurate assessment and documentation of the prognostic factors.This is now an essential tool to enable our clinical colleagues to make treatment decisions.

View Article: PubMed Central - PubMed

Affiliation: Mayday University Hospital, Croydon, Surrey, UK.

ABSTRACT
The improvements in outcomes associate with the use of preoperative therapy rather than postoperative treatment means that clinical teams are increasingly reliant on imaging to identify high-risk features of disease to determine treatment plans. For many solid tumours, including rectal cancer, validated techniques have emerged in identifying prognostic factors pre-operatively. In the MERCURY study, a standardised scanning technique and the use of reporting proformas enabled consistently accurate assessment and documentation of the prognostic factors. This is now an essential tool to enable our clinical colleagues to make treatment decisions. In this review, we describe the proforma-based reporting tool that enables a systematic approach to the interpretation of the magnetic resonance images, thereby enabling all the clinically relevant features to be adequately assessed.

Show MeSH
Related in: MedlinePlus