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Insights into Imaging
Fig. 3 | Insights into Imaging

Fig. 3

From: Re-staging and follow-up of rectal cancer patients with MR imaging when “Watch-and-Wait” is an option: a practical guide

Fig. 3

Mesorectal lymph nodes. An incomplete/poor lymph node response to NAT may be characterised by (a) a short axis ≧5 mm after NAT; b residual intermediate “tumour” signal intensity or heterogeneity on T2-WI; c Persistent high signal intensity “mucin” on T2-WI. When a lymph node presents with a complete response after NAT, a reduction in short axis superior to 70% at re-staging T2-WI may be observed (d). Also, according to ESGAR guidelines, lymph nodes with short axis < 5 mm on re-staging T2-WI (e) should be considered negative. The positive predictive value for a complete response in lymph nodes that disappear on T2-WI or DWI (f) is close to 100%. “Near-complete” responders should have no signs of persistent disease in lymph nodes and as such criteria are the same as for complete responders

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