Update to the structured MRI report for primary staging of rectal cancer: Perspective from the SAR Disease Focused Panel on Rectal and Anal Cancer

Zahra Kassam*, Rebecca Lang, Supreeta Arya, David D.B. Bates, Kevin J. Chang, Tyler J. Fraum, Kenneth A. Friedman, Jennifer S. Golia Pernicka, Marc J. Gollub, Mukesh Harisinghani, Gaurav Khatri, Elena Korngold, Chandana Lall, Sonia Lee, Michael Magnetta, Courtney Moreno, Stephanie Nougaret, Viktoriya Paroder, Raj M. Paspulati, Iva PetkovskaPerry J. Pickhardt, Hiram Shaish, Shannon Sheedy, Martin R. Weiser, Lisa Xuan, David H. Kim

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objective: To review existing structured MRI reports for primary staging of rectal cancer and create a new, freely available structured report based on multidisciplinary expert opinion and literature review. Methods: Twenty abdominal imaging experts from the Society of Abdominal Radiology (SAR)’s Disease Focused Panel (DFP) on Rectal and Anal Cancer completed a questionnaire and participated in a subsequent consensus meeting based on the RAND-UCLA Appropriateness Method. Twenty-two items were classified via a group survey as “appropriate” or “inappropriate” (defined by ≥ 70% consensus), or “needs group discussion” (defined by < 70% consensus). Certain items were also discussed with multidisciplinary team members from colorectal surgery, oncology and pathology. Results: After completion of the questionnaire, 16 (72%) items required further discussion (< 70% consensus). Following group discussion, consensus was achieved for 21 (95%) of the items. Based on the consensus meeting, a revised structured report was developed. The most significant modifications included (1) Exclusion of the T2/early T3 category; (2) Replacement of the term “circumferential resection margin (CRM)” with “mesorectal fascia (MRF)”; (3) A revised definition of “mucinous content”; (4) Creation of two distinct categories for suspicious lymph nodes (LNs) and tumor deposits; and (5) Classification of suspicious extra-mesorectal LNs by anatomic location. Conclusion: The SAR DFP on Rectal and Anal Cancer recommends using this newly updated reporting template for primary MRI staging of rectal cancer. Graphical abstract: [Figure not available: see fulltext.].

Original languageEnglish (US)
JournalAbdominal Radiology
StateAccepted/In press - 2022


  • MRI
  • MRI rectum
  • Rectal cancer
  • Synoptic reporting

ASJC Scopus subject areas

  • Gastroenterology
  • Urology
  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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