EP662 - Comparison of Magnetic Resonance Imaging (MRI) and Endoluminal Endoscopic Ultrasound (EUS) for Restaging Rectal Cancer After Neoadjuvant Chemoradiotherapy

Monday, May 12, 2025

8:05 AM – 8:10 AM PT

Location: Monitor 9, Sails Pavilion, Upper Level

ePoster Presenter(s)

JS

JUDY SHEFFEH, MD

Resident
Henry Ford Warren, St John
Sterling Height, Michigan, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

AA

Amr Aref, MD

Radiation Oncologist
Van Elslander Cancer Center
Grosse pointe Woods, Michigan, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

MB

Mohammed Barawi, NA

GI fellowship program director
Henry Ford health St John hospital
St Clair shores, Michigan, United States

Disclosure information not submitted.
AA

Amer Alame, MD

Colorectal surgeon
Henry Ford St John's Hospital
Detroit, Michigan, United States

Disclosure information not submitted.
AZ

Amer Zeni, MD

Colorectal surgeon
Henry Ford St John's Hospital
Detroit, Michigan, United States

Disclosure information not submitted.
ED

Ernesto R. Drelichman, MD

Colorectal surgeon
Henry Ford providence Hospital
Southfield, Michigan, United States

Disclosure information not submitted.
Jasneet S. Bhullar, MD, MS, FACS, FASCRS.

Clinical Associate Professor of Surgery MSU/CHM, Program Director Colorectal Surgery Fellowship MSU
Henry Ford Providence Hospital
Ascension - MSU Colorectal Surgery Fellowship, MI
Rochester Hills, Michigan, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

JUDY SHEFFEH, MD: This individual has no financial relationships with ineligible companies.

Amr Aref, MD: This individual has no financial relationships with ineligible companies.

Jasneet S. Bhullar, MD, MS, FACS, FASCRS.: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Given the high incidence and mortality of rectal cancer, accurate staging and restaging are crucial for guiding optimal interventions. However, no consensus exists on the best imaging modality for restaging after neoadjuvant chemoradiotherapy. This study aims to compare MRI and EUS in the restaging of rectal cancer following neoadjuvant chemoradiotherapy.

Methods/Interventions: We conducted a prospective observational study and enrolled patients with rectal cancer. EUS and MRI were performed at diagnosis for initial staging and repeated after neoadjuvant chemotherapy and chemoradiotherapy for restaging. A total of 43 patients were enrolled, with 25 patients (10 males, 15 females) with rectal cancer who completed neoadjuvant chemoradiotherapy meeting the study's objectives. Histopathological staging after surgery served as the reference for comparing the accuracy of restaging with EUS and MRI. The median time between the completion of neoadjuvant chemoradiotherapy and surgery was 15 weeks.

Results/Outcomes: Among the 25 patients, 12 underwent total mesorectal excision (TME), and 13 underwent local excision (LE). In the TME group, EUS matched the T stage of surgical histopathology in 2 out of 12 cases, while MRI matched in 3 out of 12. For N staging, EUS matched the surgical histopathology in 10 out of 12 cases, and MRI matched in 9 out of 12.
In the LE group, EUS matched the T stage in 11 out of 13 cases, and MRI also matched in 11 out of 13.

Conclusion/Discussion: MRI and EUS show similar accuracy in restaging local disease after neoadjuvant chemoradiotherapy, particularly in T0 cases (patients who underwent LE). Both modalities demonstrate comparable accuracy in N staging (patients who underwent TME). However, neither modality provided significant accuracy in T staging for locally advanced disease.