Extramural venous invasion in rectal cancer: overview of imaging, histopathology, and clinical implications

Hamideh Ale Ali; Richard Kirsch; Suzan Razaz; Aaditeya Jhaveri; Seng Thipphavong; Erin D Kennedy; Kartik S Jhaveri

doi:10.1007/s00261-018-1673-2

Extramural venous invasion in rectal cancer: overview of imaging, histopathology, and clinical implications

Abdom Radiol (NY). 2019 Jan;44(1):1-10. doi: 10.1007/s00261-018-1673-2.

Authors

Hamideh Ale Ali^{1

2}, Richard Kirsch^{3

4}, Suzan Razaz^{1

2}, Aaditeya Jhaveri^{5

6}, Seng Thipphavong^{7

8}, Erin D Kennedy^{9

4}, Kartik S Jhaveri^{10

11}

Affiliations

¹ Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.
² , 700 University Avenue, 2nd floor north, Toronto, ON, M5G 1X5, Canada.
³ Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
⁴ , 600 University Avenue, Mount Sinai Hospital, Toronto, ON, M5G 1X5, Canada.
⁵ Undergraduate Health Sciences Program, McMaster University, Hamilton, ON, Canada.
⁶ , 1280 Main Street, West Hamilton, ON, L8S 4L8, Canada.
⁷ Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, ON, Canada.
⁸ , 610 University Ave, 3-957, Toronto, ON, M5G 2M9, Canada.
⁹ Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
¹⁰ Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, ON, Canada. kartik.jhaveri@uhn.ca.
¹¹ , 610 University Ave, 3-957, Toronto, ON, M5G 2M9, Canada. kartik.jhaveri@uhn.ca.

PMID: 29967984
DOI: 10.1007/s00261-018-1673-2

Abstract

Objective: Extramural venous invasion (EMVI) is an independent prognostic factor for prediction of overall unfavorable outcomes in rectal cancer. While EMVI has traditionally been detected in postoperative pathologic specimens, MRI can provide this important piece of information preoperatively. This article reviews the methods of EMVI detection and their clinical implications for treatment and outcomes of rectal cancer.

Conclusion: EMVI has fundamental implications for rectal cancer prognosis and long-term outcomes. Since MRI has the advantage of preoperative detection of EMVI, it has been suggested that MRI-detected EMVI be incorporated for preoperative chemoradiotherapy (CRT) treatment stratification of rectal cancer for better patient triage and outcomes.

Keywords: Cancer staging; Chemoradiation therapy; Extramural venous invasion (EMVI); Histopathology; MRI; Rectal cancer.

Publication types

Review

MeSH terms

Humans
Magnetic Resonance Imaging / methods*
Neoplasm Invasiveness
Prognosis
Rectal Neoplasms / blood supply
Rectal Neoplasms / diagnostic imaging*
Rectal Neoplasms / pathology*
Rectum / blood supply
Rectum / diagnostic imaging
Rectum / pathology