Korean J Radiol.  2019 Jul;20(7):1003-1018. 10.3348/kjr.2018.0611.

Response Assessment with MRI after Chemoradiotherapy in Rectal Cancer: Current Evidences

  • 1Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. jslim1@yuhs.ac
  • 2Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.


Baseline magnetic resonance imaging (MRI) has become the primary staging modality for surgical plans and stratification of patient populations for more efficient neoadjuvant treatment. Patients who exhibit a complete response to chemoradiotherapy (CRT) may achieve excellent local tumor control and better quality of life with organ-preserving treatments such as local excision or even watch-and-wait management. Therefore, the evaluation of tumor response is a key factor for determining the appropriate treatment following CRT. Although post-CRT MRI is generally accepted as the first-choice method for evaluating treatment response after CRT, its application in the clinical decision process is not fully validated. In this review, we will discuss various oncologic treatment options from radical surgical technique to organ-preservation strategies for achieving better cancer control and improved quality of life following CRT. In addition, the current status of post-CRT MRI in restaging rectal cancer as well as the main imaging features that should be evaluated for treatment planning will also be described for the tailored treatment.


Rectal cancer; Magnetic resonance imaging; Pathological complete response; Neoadjuvant chemoradiotherapy; Tumor response

MeSH Terms

Magnetic Resonance Imaging*
Neoadjuvant Therapy
Quality of Life
Rectal Neoplasms*
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