الفهرس | Only 14 pages are availabe for public view |
Abstract Neoadjuvant treatment with chemoradiotherapy followed by total mesorectal excision in rectal cancer has led to a remarkable reduction in local relapse rates (Fornell-Perez et al, 2020). Hence this combination has become the standard treatment for patients with locally advanced rectal cancer; accurate identification of lymph node involvement has become crucial for prognostic and therapeutic decision making (Ge Yu-xi et al, 2020). Characterizing the involvement of lymph nodes is a very important prognostic marker in rectal cancer patients as it determines the local recurrence and overall survival rates. To date, the gold standard for lymph node characterization is histology of the surgical specimen. However, preoperative characterization is beneficial because neoadjuvant chemo-radiation has been shown to decrease the incidence of local relapse in high risk patients, such as those with lymph node involvement (Ianuş et al, 2020). Magnetic resonance imaging (MRI) is currently used widely for assessments of lymph node. While the size and morphology of lymph nodes determined on conventional MR images are often used to evaluate the extent of malignant disease, this imaging modality does not have a satisfactory sensitivity or specificity for these evaluations because malignant disease may be present even in very small nodes |