MRI restaging of rectal cancer: The RAC (Response-Anal canal-CRM) analysis joint consensus guidelines of the GRERCAR and GRECCAR groups

Stephanie Nougaret; Pascal Rousset; Doenja M J Lambregts; Monique Maas; Kirsten Gormly; Oliver Lucidarme; Serge Brunelle; Laurent Milot; Lionel Arrivé; Celine Salut; Franck Pilleul; Constance Hordonneau; Guillaume Baudin; Philippe Soyer; Vanessa Brun; Valérie Laurent; Celine Savoye-Collet; Iva Petkovska; Jean-Pierre Gerard; Eddy Cotte; Philippe Rouanet; Onofrio Catalano; Quentin Denost; Regina Beets Tan; Nora Frulio; Christine Hoeffel

doi:10.1016/j.diii.2023.02.002

MRI restaging of rectal cancer: The RAC (Response-Anal canal-CRM) analysis joint consensus guidelines of the GRERCAR and GRECCAR groups

Diagn Interv Imaging. 2023 Jul-Aug;104(7-8):311-322. doi: 10.1016/j.diii.2023.02.002. Epub 2023 Mar 16.

Authors

Stephanie Nougaret¹, Pascal Rousset², Doenja M J Lambregts³, Monique Maas³, Kirsten Gormly⁴, Oliver Lucidarme⁵, Serge Brunelle⁶, Laurent Milot⁷, Lionel Arrivé⁸, Celine Salut⁹, Franck Pilleul¹⁰, Constance Hordonneau¹¹, Guillaume Baudin¹², Philippe Soyer¹³, Vanessa Brun¹⁴, Valérie Laurent¹⁵, Celine Savoye-Collet¹⁶, Iva Petkovska¹⁷, Jean-Pierre Gerard¹⁸, Eddy Cotte¹⁹, Philippe Rouanet²⁰, Onofrio Catalano²¹, Quentin Denost²², Regina Beets Tan³, Nora Frulio⁹, Christine Hoeffel²³

Affiliations

¹ Department of Radiology IRCM, Montpellier Cancer Research Institute, 34000 Montpellier, France; INSERM, U1194, University of Montpellier, 34295, Montpellier, France. Electronic address: stephanienougaret@free.fr.
² Department of Radiology, CHU Lyon-Sud, EMR 3738 CICLY, Université Claude-Bernard Lyon 1, 69495 Pierre-Benite, France.
³ Department of Radiology, The Netherlands Cancer Institute, 1006 BE, Amsterdam, the Netherlands.
⁴ Jones Radiology, Kurralta Park, 5037, Australia; University of Adelaide, North Terrace, Adelaide, South Australia 5000, Australia.
⁵ Department of Radiology, Pitié-Salpêtrière Hospital, AP-HP, 75013 Paris, France; LIB, INSERM, CNRS, UMR7371-U1146, Sorbonne Université, 75013 Paris, France.
⁶ Department of Radiology, Institut Paoli-Calmettes, 13009 Marseille, France.
⁷ Department of Diagnostic and Interventional Radiology, Hôpital Edouard Herriot, Hospices Civils de Lyon, University of Lyon, 69003 Lyon, France.
⁸ Department of Radiology, Hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Sorbonne Université, 75013 Paris, France.
⁹ CHU de Bordeaux, Department of Radiology, Université de Bordeaux, 33000 Bordeaux, France.
¹⁰ Department of Radiology, Centre Léon Bérard, Lyon, France Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621, Lyon, France.
¹¹ Department of Radiology, CHU Estaing, 63000 Clermont-Ferrand, Cedex, France.
¹² Department of Radiology, Centre Antoine Lacassagne, 06100 Nice, France.
¹³ Department of Radiology, Hôpital Cochin, AP-HP, 75014 Paris, France; Université Paris Cité, 75006 Paris, France.
¹⁴ Department of Radiology, CHU Hôpital Pontchaillou, 35000 Rennes, France.
¹⁵ Department of Radiology, Nancy University Hospital, Université de Lorraine, 54500 Vandoeuvre-lès-Nancy, France.
¹⁶ Department of Radiology, Rouen University Hospital, 76000 Rouen, France.
¹⁷ Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
¹⁸ Department of Radiotherapy, Centre Antoine Lacassagne, 06000 Nice, France.
¹⁹ Department of Digestive Surgery, Hospices Civils de Lyon, Lyon Sud University Hospital, 69310 Pierre Bénite, France; Lyon 1 Claude Bernard University, 69100 Villeurbanne, France.
²⁰ Department of Surgery, Institut Régional du Cancer de Montpellier, Montpellier Cancer Research Institute, INSERM U1194, University of Montpellier, 34295, Montpellier, France.
²¹ Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA.
²² Department of Digestive Surgery, Hôpital Haut-Lévèque, Université de Bordeaux, 33000 Bordeaux, France.
²³ Department of Radiology, Hôpital Robert Debré & CRESTIC, URCA, 51092 Reims, France.

PMID: 36949002
DOI: 10.1016/j.diii.2023.02.002

Abstract

Purpose: To develop guidelines by international experts to standardize data acquisition, image interpretation, and reporting in rectal cancer restaging with magnetic resonance imaging (MRI).

Materials and methods: Evidence-based data and experts' opinions were combined using the RAND-UCLA Appropriateness Method to attain consensus guidelines. Experts provided recommendations for reporting template and protocol for data acquisition were collected; responses were analysed and classified as "RECOMMENDED" versus "NOT RECOMMENDED" (if ≥ 80% consensus among experts) or uncertain (if < 80% consensus among experts).

Results: Consensus regarding patient preparation, MRI sequences, staging and reporting was attained using the RAND-UCLA Appropriateness Method. A consensus was reached for each reporting template item among the experts. Tailored MRI protocol and standardized report were proposed.

Conclusion: These consensus recommendations should be used as a guide for rectal cancer restaging with MRI.

Keywords: Magnetic resonance imaging; Neoadjuvant therapy; Re-staging; Rectal neoplasms; “Watch-and-wait”.

Publication types

Practice Guideline

MeSH terms

Anal Canal*
Consensus
Humans
Magnetic Resonance Imaging / methods
Neoadjuvant Therapy
Neoplasm Staging
Rectal Neoplasms* / diagnostic imaging