By Arnd-Oliver Schäfer, Mathias Langer

Oncology usually has noticeable giant developments over fresh years. enhanced und- status of tumor biology, multidisciplinary staff judgements and an individualized remedy are cornerstones of remedy making plans for melanoma sufferers this present day. those dev- opments have challenged the imaging group with ever extra specifc questions about tumor detection, staging and treatment regulate. while this evolution applies to many tumor entities, rectal melanoma takes a great function, because it was once the popularity of convinced anatomical and pathological positive aspects of the sickness, with assistance from magnetic resonance imaging (MRI), that brought on radiology not just to help in illness mana- ment, yet actually to be a robust engine for brand spanking new innovations in rectal melanoma remedy. the continual development of hugely really expert MRI and the groundbreaking scientifc contributions of radiologists worldwide have cleared the path for s- stantial refnements of this method over the last decade. as a result, committed imaging protocols for regimen diagnostic work-up of r- tal melanoma sufferers at the moment are to be had, which may consultant multidisciplinary workforce de- sions and, together with optimized surgical procedure and chemoradiotherapy, bring about longer survival and a greater caliber of lifestyles. in addition to the scientifc advances, the iconic scientific luck of MRI within the feld of rectal melanoma is very contingent upon services. To this finish, ongoing schooling and non-stop education are important.

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However, thin-slice MRI is increasingly being employed because of its ability to show both tumor extent and depth of invasion (Brown et al. 1999). The principle of any published MRI protocol for local ­staging of rectal cancer using multichannel external phased-array coils is based on T2-weighted sequences, usually oriented in three planes. There is some debate as to whether rectal cleansing and subsequent filling with a distension media in combination with antispasmodic agents increases accuracy.

N parallel patient slices are addressed during the same TR, acquiring data from different k-space segments sequentially at different scan positions. After having passed all N scan positions, each patient slice is fully acquired as it exits the static acquisition window (Sommer et al. 2008). As demonstrated by Fautz and Kannengiesser (2006), SMS has additional beneficial properties that encourage the application of the method to abdominal imaging. The SMS technique is based on the hypothesis that similar parts of the k-space (segments) should be acquired when each slice is in the same position.

MRI prediction of CRM has some disadvantages. Difficulties in image interpretation can lead to errors when predicting the lateral margins, especially when mesorectal tumor deposits or enlarged lymph nodes are present. Rectal cancer also can provoke desmoplastic 4 Magnetic Resonance Imaging of Rectal Cancer reaction, in which fibrous tissue is formed in and around the tumor. MRI cannot reliably distinguish between fibrosis with or without tumor cells (Beets-Tan et al. 2001). In Norway, the indications for preoperative chemoradiotherapy have been extended to include patients in whom the distance from the tumor to mesorectal fascia is £ 3 mm, as measured on a goodquality MRI examination (Eriksen et al.

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