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Table 1 Different imaging planes

From: Magnetic resonance imaging (MRI) in rectal cancer: a comprehensive review

Plane

Advantage

Disadvantage

Usage

Sagittal (orthogonal)

Easy for measuring tumor height and length. Best for assessment of involvement of midline organs and structures

Structures slightly lateral to midline not easily assessed especially in female patients

Easily reproducible. Recommended

Axial (orthogonal)

Easily recognizable by clinicians. Easy for comparison with MRI or other imaging modalities, especially comparison of lymph nodes. Often best view of inguinal lymph nodes

Due to funnel-shaped form of pelvic floor and anterior curve of rectosigmoid, not enough for adequate detailed analysis in many cases

Easily reproducible. Recommended

Coronal orthogonal

None

Takes time of more important images

Not recommended

Semi-coronally parallel to anal canal

Visually informative for surgeons in low rectal tumors

Can be the same as perpendicular to pelvic floor

Not essential

Perpendicular to rectal wall

Provides best differential of T1, T2 and minimal T3. Has to be repeated at all areas where distinction between T3 and T1-2 is important

Needs either capable technicians or presence of radiologists at the time of imaging

Essential

Perpendicular to anterior mesorectal fascia

For anterior tumors or tumors with anterior component, especially in female subjects

Sometimes not necessary in cases of obvious tumor growth into anterior structures

Important in selected cases

Perpendicular to pelvic floor

For tumors growing dorsally and laterally close to pelvic floor. Can provide coverage of mesorectal lymph nodes

Not necessary in all cases

Important in selected cases

Perpendicular to anal canal

Most important plane for low tumors at the level of pelvic floor or lower down

Not essential for tumors completely above the pelvic floor

Not essential for tumors completely above the pelvic floor