MRI can forecast the likelihood of rectal cancer returning or metastasizing in patients who have completed chemotherapy and radiation, according to new research.
Magnetic resonance imaging (MRI) has the potential to help many rectal cancer patients avoid invasive surgeries that may lead to long-term effects, as suggested by recent studies.
Research conducted by Arun Krishnaraj, MD, MPH, and his team at UVA Cancer Center shows that MRI can assess patient results and the chance of tumor recurrence or spread in those who have received chemotherapy and radiation therapies.
This data can significantly aid in choosing the most effective treatment plan, including whether a patient might opt for a “watch and wait” strategy instead of undergoing surgery. In a watch-and-wait scenario, patients are monitored for signs of cancer returning, which can lead to uncertainty and anxiety regarding their health.
The insights provided by MRI would not only benefit healthcare professionals but also offer reassurance to patients, according to the latest research findings.
“Patients who have received chemotherapy and radiation for rectal cancer often worry about whether their cancer has resolved or if there is residual disease. With advanced MRI techniques, we have significantly improved our ability to predict if any cancer remains and whether it is likely to recur or spread,” explained Krishnaraj, who leads UVA Health’s Division of Body Imaging among other roles. “No one wishes to undergo surgery if it can be avoided. With this powerful tool, we can help determine who can safely avoid surgery after initial treatment.”
Advancing Rectal Cancer Care
Cases of colorectal cancer are on the rise in younger adults—those under the age of 50—despite a decline in older populations. According to the American Cancer Society, approximately 1 in 23 men and 1 in 25 women will face this disease.
Initially, rectal cancer is typically treated with radiation and chemotherapy; however, some patients may require a procedure known as “total mesorectal excision,” which involves the removal of a large portion of the bowel. This procedure can be lifesaving but can also lead to significant lifestyle changes, such as needing a permanent colostomy bag or experiencing sexual dysfunction.
To assist patients in making informed decisions and achieving optimal results, Krishnaraj and his team sought to investigate if MRI could predict the outcomes of the watch-and-wait tactic. They reviewed data from the Organ Preservation in Renal Adenocarcinoma (OPRA) trial to examine how MRI results corresponded with patient outcomes. Their analysis included data from 277 patients with an average age of 58, who had their cancer stage assessed through MRI, with a follow-up period averaging just over four years.
After analyzing the information, the researchers concluded that MRI is a valuable tool for predicting patient survival, the chance of cancer recurrence, and the likelihood of maintaining bowel integrity.
Moreover, the researchers believe the effectiveness of this “MRI crystal ball” could be enhanced by integrating findings from endoscopies conducted post-treatment. They advocate for further exploration into this combined approach, which could prove beneficial for both doctors and patients.
“I am hopeful that ongoing advancements in MRI and additional methods like endoscopy will yield better insights into future outcomes,” Krishnaraj stated. “Our ultimate goal is to achieve nearly 99% predictive accuracy to better inform patients about their risk of recurrence or spread after treatment. We may not be there yet, but that is the target we are striving for.”
Enhancing patient care is a crucial objective for UVA Cancer Center, recognized as one of the 57 cancer centers nationwide designated as “comprehensive” by the National Cancer Institute—honoring these facilities for their top-tier cancer care and research initiatives.
