Abstract
Objective
To review existing structured MRI reports for primary staging of rectal cancer and create a new, freely available structured report based on multidisciplinary expert opinion and literature review.
Methods
Twenty abdominal imaging experts from the Society of Abdominal Radiology (SAR)’s Disease Focused Panel (DFP) on Rectal and Anal Cancer completed a questionnaire and participated in a subsequent consensus meeting based on the RAND-UCLA Appropriateness Method. Twenty-two items were classified via a group survey as “appropriate” or “inappropriate” (defined by ≥ 70% consensus), or “needs group discussion” (defined by < 70% consensus). Certain items were also discussed with multidisciplinary team members from colorectal surgery, oncology and pathology.
Results
After completion of the questionnaire, 16 (72%) items required further discussion (< 70% consensus). Following group discussion, consensus was achieved for 21 (95%) of the items. Based on the consensus meeting, a revised structured report was developed. The most significant modifications included (1) Exclusion of the T2/early T3 category; (2) Replacement of the term “circumferential resection margin (CRM)” with “mesorectal fascia (MRF)”; (3) A revised definition of “mucinous content”; (4) Creation of two distinct categories for suspicious lymph nodes (LNs) and tumor deposits; and (5) Classification of suspicious extra-mesorectal LNs by anatomic location.
Conclusion
The SAR DFP on Rectal and Anal Cancer recommends using this newly updated reporting template for primary MRI staging of rectal cancer.
Graphical abstract
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Acknowledgements
The authors would like to acknowledge the following Rectal and Anal DFP Members for their lively discussions and contributions to this topic during our monthly meetings: Regina Beets-Tan, Greg DePrisco, Randy Ernst, Dhakshina Ganeshan, Thomas Hope, Natally Horvat, Kartik Jhaveri, Harmeet Kaur, Neeraj Lalwani, Maia Margishvili Rauch, as well as DFP Consultants and Working Group Members. We would like to also acknowledge Ms. Jiya Agrawal for her technical assistance on this publication.
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Kassam, Z., Lang, R., Arya, S. et al. Update to the structured MRI report for primary staging of rectal cancer. Abdom Radiol 47, 3364–3374 (2022). https://doi.org/10.1007/s00261-022-03612-3
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DOI: https://doi.org/10.1007/s00261-022-03612-3