الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Rectal cancer constitutes a distinct subset of colorectal carcinoma necessitating a dedicated multidisciplinary approach through the journey of diagnosis and treatment.
Neoadjuvant chemo-radiotherapy (CRT) has the advantage of tumor down staging, with a chance of pathologic complete response (pCR) with reflection on locoregional recurrence rates, and increased overall survival
Conventional Magnetic Resonance Imaging MRI has gained wide acceptance in pretreatment evaluation of rectal cancer, especially in terms of local staging, yet Sensitivity and specificity in evaluating the response to Neoadjuvant therapy and post-operative assessment is less. Due to limitations of the conventional MRI which based on classical morphological evaluation, the “multiparameteric MRI“ was introduced comprising the addition of functional MRI sequences namely diffusion and perfusion to routine MRI rectal protocol.
This study was carried out to highlight the value of conventional MRI with addition of functional Technique by diffusion and perfusion analysis in assessment of response to Neoadjuvant therapy and post-operative follow up for a more accurate method to predict the outcome of the disease.
This study was conducted at Ismailia Cancer and Suez Canal University Hospitals. Patients were recruited from Oncology and Surgical Oncology clinics. All Patients were assessed clinically, stage II and III referred to neoadjuvant therapy after having their initial MRI baseline scan. Patients had their MRI (post CRT) within 8 – 10 weeks, then they underwent surgical intervention in the form of anterior resection with TME or APR.
We found that Functional magnetic resonance imaging (MRI) biomarkers have greater potential compared to standard T2-weighted sequences for therapeutic response prediction in locally advanced rectal cancer as most of our patients had statistical significant dibefore and after chemotherapy in DW, ADC, Ktrans, and AUC.