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LETTER TO EDITOR  
Year : 2011  |  Volume : 21  |  Issue : 1  |  Page : 69-70
MRI criterion for prediction of involvement of circumferential resection margin in rectal cancer


The Ottawa Hospital, Box 232, General Campus-Room 1466e, 501 Smyth Road, Ottawa, Ontario K1H8L6, Canada

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Date of Web Publication22-Jan-2011
 

How to cite this article:
Gupta M, Gupta R. MRI criterion for prediction of involvement of circumferential resection margin in rectal cancer. Indian J Radiol Imaging 2011;21:69-70

How to cite this URL:
Gupta M, Gupta R. MRI criterion for prediction of involvement of circumferential resection margin in rectal cancer. Indian J Radiol Imaging [serial online] 2011 [cited 2019 Jul 23];21:69-70. Available from: http://www.ijri.org/text.asp?2011/21/1/69/76065
Dear Sir,

We read the article "MRI in T staging of rectal cancer: How effective is it?" by Mulla et al., [1] published recently in this journal. We agree with the authors that MRI is moderately accurate in T staging for rectal cancer. As pointed out by the authors, the status of the circumferential resection margin (CRM) is very important as this will decide whether a patient needs neoadjuvant chemo radiotherapy before surgery. Involvement of the CRM is an independent predictor of increased chance of recurrence after surgery. Currently, MRI is the modality of choice to evaluate the status of the CRM.

However, it would be interesting to know the criterion used by the authors for predicting the involvement of the CRM. Beets et al. [2] have shown that on MRI, a distance of 6 mm will predict a tumor distance of at least 2 mm on histology with 97% confidence and a crucial distance of 1 mm can be predicted by a distance of 5 mm on MRI with high confidence. Other authors [3] have also confirmed the same fact in their studies, and currently on MRI, 5 mm is the cutoff used for prediction of involvement of the CRM in our institution. Any tumor within 5 mm of the CRM will have a high chance of involvement of the CRM.

 
   References Top

1.Mulla MG, Deb R, Singh R. MRI in T staging of rectal cancer: How effective is it? Indian J Radiol Imaging 2010;20:118-121.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Beets-Tan RG, Beets GL, Vliegen RF, Kessels AG, Van Boven H, De Bruine A, et al. Accuracy of magnetic resonance imaging in prediction of tumor-free resection margin in rectal cancer surgery. Lancet 2001;357:497-504.   Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.Bissett IP, Fernando CC, Hough DM, Cowan BR, Chau KY, Young AA, et al. Identification of the fascia propria by magnetic resonance imaging and its relevance to preoperative assessment of rectal cancer. Dis Colon Rectum 2001;44:259-65.  Back to cited text no. 3
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Correspondence Address:
Mudit Gupta
The Ottawa Hospital, Box 232, General Campus-Room 1466e, 501 Smyth Road, Ottawa, Ontario K1H8L6
Canada
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.76065

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1 Authoręs reply: MRI in T staging of rectal cancer: How effective is it?
Mulla, M.
Indian Journal of Radiology and Imaging. 2011; 21(1): 70
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