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Magnetic Resonance Imaging in Rectal Cancer: Ability to Predict Response to Neo-adjuvant Treatment

Asma Souid, Chiraz Chammakhi Jemli, Dhafer Haddad and Anis Ben Maam

Magnetic Resonance Imaging (MRI) is recommended in recent guidelines for the initial staging done at the primary diagnosis of a cancer of the lower two thirds of the rectum, selecting patients requiring a neoadjuvant treatment in order to reduce local recurrence. Radiotherapy with concurrent chemotherapy has shown its effectiveness in improving the patient outcome and adjusting the surgeon approach by downsizing and downstaging tumors as well as increasing R0 resection. However this response has shown to be variable. Whereas, minimizing the operative approaches without compromising the oncological control re- quires a very effective and accurate selection of good responder patients to chemo radiotherapy on the one hand and an accurate assessment of their response once the preoperative treatment is achieved on the other hand.