Local recurrence of rectal cancer after treatment is a significant problem despite recent advances in surgery and adjuvant therapy. Appropriate follow-up is a cornerstone of early detection of local recurrence in hopes of timely treatment. Endorectal ultrasound is a readily available technique that can be performed in the outpatient's setting during regular follow-up and allows the detection of early and asymptomatic local recurrences. Endorectal ultrasound can also be used to obtain tissue diagnosis on the lesion in question. Other imaging modalities, including magnetic resonance imaging and positron emission tomography scanning, have been shown to be beneficial in both preoperative as well as postoperative settings. Although additional research is needed, successful detection of early recurrences most likely lies in close follow-up and combination of various imaging techniques.
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