Jane Anna Clare Colville MBBCH, Presenter: Nothing to Disclose

Marc Jeffrey Gollub MD, Abstract Co-Author: Nothing to Disclose

Liang Wang MD, Abstract Co-Author: Nothing to Disclose

Philip Paty, Abstract Co-Author: Nothing to Disclose

Lawrence Howard Schwartz MD, Abstract Co-Author: Nothing to Disclose

To assess the accuracy of MRI in identifying recurrent disease and in predicting organ invasion.

Between January 1999 and June 2003 139 patients were evaluated for suspected recurrent rectal carcinoma in our institution. Forty six patients fulfilled the study's inclusion criteria (21 male and 25 female). The mean age was 59 years and 11 months (range 29 years- 80 years and 11 months). Tumor recurrence was suspected if there was a rise in CEA level and/ or the the patient experienced clinical symptoms. MR imaging was performed using a 1.5 Tesla system. Two blinded, independent attending radiologists retrospectively reviewed the MR studies evaluating the extent of disease and organ involvement grading the recurrences on a five point ROC scale. Of the operative candidates, eight patients were found to have extensive unresectable disease and biopsies were obtained. Clinical notes were reviewed and correlation was made subsequently with radiological, surgical and pathological findings.

156 areas of recurrence were identified. The three most common radiological sites of recurrence were rectum (n=33, 21.1%), presacral fascia (n=31, 19.9%) and vagina (n=11, 7.1%). The concordance rate between the radiologists was 85.3%. Thirty three patients had surgery yielding pathology for correlation. Pathology identified 77 specific areas/ organs of recurrence, 72 were radiologically highly suspicious for recurrence giving a radiological accuracy of 93.5%.

MRI can adequately identify the majority of sites of recurrent disease within the pelvis.

Colville, J, Gollub, M, Wang, L, Paty, P, Schwartz, L, Recurrent Rectal Carcinoma: MRI Evaluation.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4412046.html