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Techniques and trouble-shooting in high spatial resolution thin slice MRI for rectal cancer

¹ Department of Radiology, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, ² Pelican Cancer Foundation, Pelican Centre, North Hampshire Hospital, Aldermaston Road, Basingstoke, Hants RG24 9NA, ³ Siemens Medical, Siemens House, Oldbury, Bracknell, Berkshire RG12 8FZ and ⁴ Department of Radiology, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK

Correspondence: Dr Gina Brown, Consultant Radiologist and Honorary Senior Lecturer, Department of Radiology, The Royal Marsden Hospital NHS Trust, Downs Road, Sutton, Surrey SM2 5PT, UK

MRI is increasingly advocated as an optimal method of staging rectal cancer. The technique enables depiction of the relationship of tumour to the mesorectal fascia and may thus identify tumours at risk of positive circumferential margin involvement at surgery. Depth of extramural spread may also be accurately measured and tumour deposits within the mesorectum are shown. It is important that a high spatial resolution technique is used in order to accurately depict these features and care should be taken in ensuring that images acquired cover the entire rectal tumour and mesorectum. This paper describes the technique of high spatial resolution rectal cancer imaging and the potential technical pitfalls in acquiring good quality images. Important factors to consider include: adequate scan duration to achieve high spatial resolution images with sufficient signal to noise ratio, careful positioning of the pelvic phased array coil, use of T₂ weighted turbo spin-echo rather than T₁ weighted imaging and careful planning of scans to ensure that images are obtained perpendicular to the rectal wall.

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