多模态成像指导全直肠系膜切除术后的原发性和复发性直肠腺癌治疗

IF 5.6 Q1 ONCOLOGY
Joshua D Shur, Sheng Qiu, Edward Johnston, Diana Tait, Nicos Fotiadis, Christos Kontovounisios, Shahnawaz Rasheed, Paris Tekkis, Angela Riddell, Dow-Mu Koh
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引用次数: 0

摘要

直肠肿瘤延伸到全直肠系膜切除术(TME)平面以外(beyond-TME),在计划治疗时需要特别的多学科专业知识和肿瘤学考虑。影像学应用于治疗路径的各个阶段,如局部肿瘤分期/预后、创建基于影像学的 "路线图 "以规划手术,从而达到最佳的肿瘤清除效果、识别与治疗相关的并发症(可能适合放射学引导的介入治疗)以及检测复发或转移性疾病(可能适合放射学引导的消融治疗)。作为晚期肿瘤的潜在根治性手术,Beyond-TME 和肠外手术已被越来越多的人接受。了解当前成像技术的作用、技术和陷阱对于参与治疗这些患者的放射科医生和可能遇到接受监测的患者或出现手术并发症或腹部并发病变的患者的普通放射科医生都很重要。本综述旨在概述当前和新出现的影像学在TME以外和复发直肠恶性肿瘤患者中的作用,重点是TME以外情况下的影像解读和手术规划实用技巧。关键词腹部/消化道 直肠 肿瘤学 © RSNA, 2024.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multimodality Imaging to Direct Management of Primary and Recurrent Rectal Adenocarcinoma Beyond the Total Mesorectal Excision Plane.

Rectal tumors extending beyond the total mesorectal excision (TME) plane (beyond-TME) require particular multidisciplinary expertise and oncologic considerations when planning treatment. Imaging is used at all stages of the pathway, such as local tumor staging/restaging, creating an imaging-based "roadmap" to plan surgery for optimal tumor clearance, identifying treatment-related complications, which may be suitable for radiology-guided intervention, and to detect recurrent or metastatic disease, which may be suitable for radiology-guided ablative therapies. Beyond-TME and exenterative surgery have gained acceptance as potentially curative procedures for advanced tumors. Understanding the role, techniques, and pitfalls of current imaging techniques is important for both radiologists involved in the treatment of these patients and general radiologists who may encounter patients undergoing surveillance or patients presenting with surgical complications or intercurrent abdominal pathology. This review aims to outline the current and emerging roles of imaging in patients with beyond-TME and recurrent rectal malignancy, focusing on practical tips for image interpretation and surgical planning in the beyond-TME setting. Keywords: Abdomen/GI, Rectum, Oncology © RSNA, 2024.

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