• Lymph nodes
• Magnetic resonance imaging
• Pathology
• Rectal neoplasms

• 2024-1-1022 Capital's Funds for Health Improvement and Research
• 2024-1-1022 Capital's Funds for Health Improvement and Research
• 2024-1-1022 Capital's Funds for Health Improvement and Research
• 2024-1-1022 Capital's Funds for Health Improvement and Research
• 2024-1-1022 Capital's Funds for Health Improvement and Research
• 2024-1-1022 Capital's Funds for Health Improvement and Research
• 2024-1-1022 Capital's Funds for Health Improvement and Research
• 2024-1-1022 Capital's Funds for Health Improvement and Research
• L242038 Beijing Natural Science Foundation
• L242038 Beijing Natural Science Foundation
• L242038 Beijing Natural Science Foundation
• L242038 Beijing Natural Science Foundation
• L242038 Beijing Natural Science Foundation
• L242038 Beijing Natural Science Foundation
• L242038 Beijing Natural Science Foundation
• L242038 Beijing Natural Science Foundation
• U24A20752 National Natural Science Foundation of China
• U24A20752 National Natural Science Foundation of China
• U24A20752 National Natural Science Foundation of China
• U24A20752 National Natural Science Foundation of China
• U24A20752 National Natural Science Foundation of China
• U24A20752 National Natural Science Foundation of China
• U24A20752 National Natural Science Foundation of China
• U24A20752 National Natural Science Foundation of China

• Lymph node metastasis
• Magnetic resonance imaging
• Radiomics
• Rectal cancer

• Universitatea Babes-Bolyai

• Computed tomography
• Drug delivery systems
• Imaging
• Lymph node metastasis
• Magnetic resonance

• Humans
• Lymphatic Metastasis/pathology
• Lymph Nodes/diagnostic imaging
• Lymph Nodes/pathology
• Drug Delivery Systems

• 2018M630883 Postdoctoral Science Foundation of China
• ZY2023Q015 Hubei Province Chinese Medicine Research Project
• 2023AFB665 Natural Science Foundation of Hubei Province
• Medical Young Talents Program of Hubei Province
• Wuhan Young Medical Talents Training Project

• Humans
• Male
• Middle Aged
• Extranodal Extension
• Prognosis
• Prospective Studies
• Retrospective Studies
• Rectal Neoplasms/diagnostic imaging
• Magnetic Resonance Imaging
• Neoplasms, Second Primary

• lymph node metastases
• ultrasmall superparamagnetic iron oxide
• magnetic resonance imaging
• reading algorithm
• head and neck cancer

• MRI
• Mesorectal lymph nodes
• N-staging
• Neoadjuvant therapy
• Node by node
• Nomogram
• Rectal cancer
• Restaging

• Histopathology
• MRI
• Mesorectal lymph nodes
• Node-by-node
• Rectal cancer

• lateral lymph node dissection
• lateral lymph node metastasis
• machine learning
• preoperative diagnosis
• rectal cancer

• Contrast-enhanced ultrasound
• breast cancer
• fine-needle aspiration cytology
• sentinel lymph node

• Biopsy, Fine-Needle
• Breast Neoplasms/diagnostic imaging
• Breast Neoplasms/pathology
• Contrast Media
• Feasibility Studies
• Female
• Humans
• Lymph Nodes/pathology
• Retrospective Studies
• Sentinel Lymph Node/diagnostic imaging
• Sentinel Lymph Node/pathology

The current status and future prospects for diagnosis and treatment of lateral pelvic lymph node (LPLN) metastasis of rectal cancer are described in this review. Magnetic resonance imaging (MRI) is recommended for the diagnosis of LPLN metastasis. A LPLN-positive status on MRI is a strong risk factor for metastasis, and evaluation by MRI is important for deciding treatment strategy. LPLN dissection (LPLD) has an advantage of reducing recurrence in the lateral pelvis but also has a disadvantage of complications; therefore, LPLD may not be appropriate for cases that are less likely to have LPLN metastasis. Radiation therapy (RT) and chemoradiation therapy (CRT) have limited effects in cases with suspected LPLN metastasis, but a combination of preoperative CRT and LPLD may improve the treatment outcome. Thus, RT and CRT plus selective LPLD may be a rational strategy to omit unnecessary LPLD and produce a favorable treatment outcome.

• Diagnosis
• Treatment
• Rectal cancer
• Lateral pelvic lymph node metastasis
• Lateral pelvic lymph node dissection
• Radiotherapy

• Lymph node
• Magnetic resonance imaging
• Metastasis
• Rectal cancer
• USPIO

In head and neck cancer, the presence of nodal disease is a strong determinant of prognosis and treatment. Despite the use of modern multimodality diagnostic imaging, the prevalence of occult nodal metastases is relatively high. This is why in clinically node negative head and neck cancer the lymphatics are treated “electively” to eradicate subclinical tumor deposits. As a consequence, many true node negative patients undergo surgery or irradiation of the neck and suffer from the associated and unnecessary early and long-term morbidity. Safely tailoring head and neck cancer treatment to individual patients requires a more accurate pre-treatment assessment of nodal status. In this review, we discuss the potential of several innovative diagnostic approaches to guide customized management of the clinically negative neck in head and neck cancer patients.

• FDG-PET/CT
• elective neck treatment
• head and neck cancer
• lymph node metastases
• nanoparticles enhanced MRI
• nodal staging
• sentinel lymph node identification

According to the main international clinical guidelines, the recommended treatment for locally-advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery. However, doubts have been raised about the appropriate definition of clinical complete response (cCR) after neoadjuvant therapy and the role of surgery in patients who achieve a cCR. Surgical resection is associated with significant morbidity and decreased quality of life (QoL), which is especially relevant given the favourable prognosis in this patient subset. Accordingly, there has been a growing interest in alternative approaches with less morbidity, including the organ-preserving watch and wait strategy, in which surgery is omitted in patients who have achieved a cCR. These patients are managed with a specific follow-up protocol to ensure adequate cancer control, including the early identification of recurrent disease. However, there are several open questions about this strategy, including patient selection, the clinical and radiological criteria to accurately determine cCR, the duration of neoadjuvant treatment, the role of dose intensification (chemotherapy and/or radiotherapy), optimal follow-up protocols, and the future perspectives of this approach. In the present review, we summarize the available evidence on the watch and wait strategy in this clinical scenario, including ongoing clinical trials, QoL in these patients, and the controversies surrounding this treatment approach.

• Watch and wait
• Rectal cancer
• Clinical complete response
• Organ preservation
• Dose intensification

• Chemoradiotherapy
• Humans
• Neoadjuvant Therapy
• Neoplasm Recurrence, Local
• Quality of Life
• Rectal Neoplasms/diagnostic imaging
• Rectal Neoplasms/therapy
• Treatment Outcome
• Watchful Waiting

• MRI of rectum
• Rectal cancers
• baseline staging
• mesorectum

Baseline magnetic resonance imaging (MRI) has become the primary staging modality for surgical plans and stratification of patient populations for more efficient neoadjuvant treatment. Patients who exhibit a complete response to chemoradiotherapy (CRT) may achieve excellent local tumor control and better quality of life with organ-preserving treatments such as local excision or even watch-and-wait management. Therefore, the evaluation of tumor response is a key factor for determining the appropriate treatment following CRT. Although post-CRT MRI is generally accepted as the first-choice method for evaluating treatment response after CRT, its application in the clinical decision process is not fully validated. In this review, we will discuss various oncologic treatment options from radical surgical technique to organ-preservation strategies for achieving better cancer control and improved quality of life following CRT. In addition, the current status of post-CRT MRI in restaging rectal cancer as well as the main imaging features that should be evaluated for treatment planning will also be described for the tailored treatment.

• Magnetic resonance imaging
• Neoadjuvant chemoradiotherapy
• Pathological complete response
• Rectal cancer
• Tumor response

• MRI
• Protocol
• Rectal cancer
• Reporting
• Staging

• Magnetic resonance imaging
• Prognostic factors
• Rectal cancer
• Staging
• Structured report

• Chemo-radiotherapy
• DWI
• LARC

• Humans
• Magnetic Resonance Imaging/methods
• Neoplasm Staging
• Rectal Neoplasms/diagnostic imaging
• Rectal Neoplasms/pathology
• Rectum/diagnostic imaging
• Rectum/pathology
• Tomography, X-Ray Computed/methods

• solubility
• nanomedicine
• cancer
• spectrophotometry
• emulsions
• biomedical mri
• nanomagnetics
• nanofabrication
• tumours
• nanoparticles
• magnetic particles
• molecular biophysics
• light scattering
• proteins
• cellular biophysics
• fourier transform spectra
• superparamagnetism
• polymers
• transmission electron microscopy
• iron compounds
• physicochemical characterisation
• superparamagnetic iron oxide nanoparticles
• novel targeting cancer detection
• anti‐epidermal growth factor receptor monoclonal antibody
• anti‐egfr‐spion
• biocompatibility
• targeted magnetic resonance imaging contrast agent
• egfr‐specific detection
• egfr expressing tumour cells
• biocompatible polymers
• plga‐peg‐aldehyde nanoparticles
• modified water‐in‐oil‐in‐water double emulsion method
• egfr antibody
• aldehyde‐amine reaction
• synthesised conjugates were characterised using fourier
• transmission electron microscopy images
• synthesised nanoprobes
• egfr detection
• size 25.0 nm
• fe₃ o₄

• A549 Cells
• Antibodies, Monoclonal/chemistry
• Antibodies, Monoclonal/metabolism
• Contrast Media/chemistry
• Drug Carriers/chemistry
• Drug Carriers/metabolism
• ErbB Receptors/chemistry
• ErbB Receptors/metabolism
• Humans
• Magnetic Resonance Imaging/methods
• Magnetite Nanoparticles/chemistry
• Neoplasms/diagnostic imaging
• Particle Size

• MRI
• lymph node metastasis
• lymphovascular invasion
• rectal cancer
• volumetry

• Accuracy
• Chemoradiotherapy
• Colorectal cancer
• Lymph node metastasis
• Staging

• Chemoradiation
• Lymph nodes
• MRI
• Rectal cancer
• Staging

• Adult
• Aged
• Aged, 80 and over
• Chemoradiotherapy, Adjuvant
• Female
• Humans
• Lymph Nodes/diagnostic imaging
• Lymph Nodes/pathology
• Lymphatic Metastasis
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neoadjuvant Therapy
• Neoplasm Staging
• Postoperative Period
• Rectal Neoplasms/pathology
• Rectal Neoplasms/therapy
• Sensitivity and Specificity
• Tumor Burden

Magnetic resonance imaging (MRI) is still the most commonly used imaging technique for the diagnosis of rectal cancer with the highest degree of accuracy, and it is also recommended by the National Comprehensive Cancer Network, European Society for Medical Oncology, and Chinese guidelines for diagnosis and treatment of colorectal cancer. The application of diffusion weighted imaging, apparent diffusion coefficient, diffusion weighted imaging with background signal suppression, intravoxel incoherent motion, perfusion imaging, magnetic resonance spectroscopy, and molecular imaging has provided many choices for tumor detection and preoperative staging, differential diagnosis of benign and malignant rectum lesions, postoperative follow-up, recurrence monitoring, and efficacy evaluation. We believe that with the development of basic theory and related technology, MRI for rectal cancer assessment will become more efficient.

• Rectal cancer
• Magnetic resonance imaging
• Tumor staging
• Lymphatic metastasis

• MR angiography, sentinel lymph node
• Superparamagnetic resonance iron oxide
• contrast agent
• lymph node metastasis
• magnetic resonance imaging (MRI)
• superparamagnetic iron oxide (SPIO)

• DWI
• locally advanced rectal cancer
• lymph node staging
• nodal restaging
• organ preservation

• Brain tumor
• Gold nanoparticle
• Iron oxide nanoparticle
• Liposomes
• Molecular imaging
• Molecular targeting

• Colorectal neoplasms
• MRI, functional
• Molecular imaging
• Multimodal imaging
• Perfusion imaging

In rectal cancer management, accurate staging by magnetic resonance imaging, neo-adjuvant treatment with the use of radiotherapy, and total mesorectal excision have resulted in remarkable improvement in the oncological outcomes. However, there is substantial discrepancy in the therapeutic approach and failure to adhere to international guidelines among different Greek-Cypriot hospitals. The present guidelines aim to aid the multidisciplinary management of rectal cancer, considering both the local special characteristics of our healthcare system and the international relevant agreements (ESMO, EURECCA). Following background discussion and online communication sessions for feedback among the members of an executive team, a consensus rectal cancer management was obtained. Statements were subjected to the Delphi methodology voting system on two rounds to achieve further consensus by invited multidisciplinary international experts on colorectal cancer. Statements were considered of high, moderate or low consensus if they were voted by ≥80%, 60-80%, or <60%, respectively; those obtaining a low consensus level after both voting rounds were rejected. One hundred and two statements were developed and voted by 100 experts. The mean rate of abstention per statement was 12.5% (range: 2-45%). In the end of the process, all statements achieved a high consensus. Guidelines and algorithms of diagnosis and treatment were proposed. The importance of centralization, care by a multidisciplinary team, adherence to guidelines, and personalization is emphasized.

• Delphi
• Guidelines
• consensus
• rectal cancer
• surgical treatment

• Cancer staging
• Lymph nodes
• Magnetic resonance imaging
• Neoadjuvant chemoradiation therapy
• Rectal cancer

Imaging in rectal cancer has a vital role in staging disease, and in selecting and optimizing treatment planning. High-resolution MRI (HR-MRI) is the recommended method of first choice for local staging of rectal cancer for both primary staging and for restaging after preoperative chemoradiation (CT-RT). HR-MRI helps decide between upfront surgery and preoperative CT-RT. It provides high accuracy for prediction of circumferential resection margin at surgery, T category, and nodal status in that order. MRI also helps assess resectability after preoperative CT-RT and decide between sphincter saving or more radical surgery. Accurate technique is crucial for obtaining high-resolution images in the appropriate planes for correct staging. The phased array external coil has replaced the endorectal coil that is no longer recommended. Non-fat suppressed 2D T2-weighted (T2W) sequences in orthogonal planes to the tumor are sufficient for primary staging. Contrast-enhanced MRI is considered inappropriate for both primary staging and restaging. Diffusion-weighted sequence may be of value in restaging. Multidetector CT cannot replace MRI in local staging, but has an important role for evaluating distant metastases. Positron emission tomography-computed tomography (PET/CT) has a limited role in the initial staging of rectal cancer and is reserved for cases with resectable metastatic disease before contemplating surgery. This article briefly reviews the comprehensive role of imaging in rectal cancer, describes the role of MRI in local staging in detail, discusses the optimal MRI technique, and provides a synoptic report for both primary staging and restaging after CT-RT in routine practice.

• Imaging
• MRI
• local staging
• staging rectal cancer

Imaging studies are a major component in the evaluation of patients for the screening, staging and surveillance of colorectal cancer. This review presents commonly encountered findings in the diagnosis and staging of patients with colorectal cancer using computed tomography (CT) colonography, magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT colonography. CT colonography provides important information for the preoperative assessment of T staging. Wall deformities are associated with muscular or subserosal invasion. Lymph node metastases from colorectal cancer often present with calcifications. CT is superior to detect calcified metastases. Three-dimensional CT to image the vascular anatomy facilitates laparoscopic surgery. T staging of rectal cancer by MRI is an established modality because MRI can diagnose rectal wall laminar structure. N staging in patients with colorectal cancer is still challenging using any imaging modality. MRI is more accurate than CT for the evaluation of liver metastases. PET/CT colonography is valuable in the evaluation of extra-colonic and hepatic disease. PET/CT colonography is useful for obstructing colorectal cancers that cannot be traversed colonoscopically. PET/CT colonography is able to localize synchronous colon cancers proximal to the obstruction precisely. However, there is no definite evidence to support the routine clinical use of PET/CT colonography.

• Colorectal cancer
• Preoperative evaluation
• T staging
• N staging
• Liver metastasis
• Magnetic resonance imaging
• Computed tomography colonography
• Positron emission tomography

• Colonography, Computed Tomographic
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/diagnostic imaging
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/surgery
• Humans
• Lymphatic Metastasis
• Magnetic Resonance Imaging
• Multimodal Imaging
• Neoplasm Invasiveness
• Neoplasm Staging
• Positron-Emission Tomography
• Predictive Value of Tests

Accurate diagnosis of lymph node metastasis is crucial in treatment planning for cancer patients. Despite the use of various parameters, making correct diagnosis of a small metastatic or a hyperplastic benign node is still a challenge. In this study, we evaluated the feasibility of detecting lymph node metastasis using a new ultrasmall superparamagnetic iron oxide particle, PJY10, in a rabbit model.

To make metastatic and benign lymph nodes, either VX2 carcinoma or fecal material suspension was inoculated into thighs of 56 rabbits three weeks or three days before magnetic resonance (MR) imaging, respectively. T2*-weighted 3T MR imaging was performed before and 24 hours after PJY10 injection (5.2 [n = 15], 7.8 [n = 17], and 10.4 [n = 24] mg Fe/kg). MR images were correlated with pathologic results to calculate sensitivity and specificity. Quantitative analysis of the signal intensity (SI) – number of voxels_[low] (the fraction of the number of voxels with the normalized SI on the postcontrast image lower than that on the precontrast image) and mean SI ratio – was also performed for each lymph node.

Sensitivities were 100% at all three dosages, whereas specificity increased with increasing dosage (89% at 10.4 mg Fe/kg). The benign nodes had a significantly higher number of voxels_[low] and a lower mean SI ratio than the metastatic nodes at the dosage of 10.4 mg Fe/kg (P<.001). Az values were 0.905 for the number of voxels_[low] and 0.952 for the mean SI ratio. The number of voxels_[low] (P = .019) and the mean SI ratio (P = .034) had significant correlations with the histopathologic area ratio of metastatic foci in the metastatic nodes at 10.4 mg Fe/kg.

PJY10 enabled clear demonstration of lymph node metastasis with high sensitivity and specificity at its optimal dosage of 10.4 mg Fe/kg.

USPIO is a contrast agent for MRI that can generate T2W images with low signal intensities. After subcutaneous or intravenous injection of USPIO, normal lymph node tissues uptake these nano-particles, but tumor cells do not. Thus, tumor metastasis can be detected using this contrast agent.

The aim of this study was to access the feasibility of USPIO enhanced MRI for the detection of cervical lymph node metastasis in a pyriform sinus carcinoma animal model and to investigate the ability of USPIO to enhance images of cervical lymph node metastases.

Twenty New Zealand rabbits were randomly divided into tumor and inflammatory groups, and each group contained 10 rabbits. In the inflammatory group, a 0.5 ml egg yolk emulsion was injected into the sub-mandibular muscle of the rabbits to induce an inflammatory reaction in their cervical lymph nodes. In the tumor group, a VX2 tumor tissue suspension was transplanted into the pyriform sinus sub-mucosa of the rabbits using direct laryngoscope. Four weeks after the tumor or egg yolk injection, MRIs were performed before and after USPIO injection to observe the imaging enhancement features of USPIO. After that, a histo-pathological analysis was performed for all rabbits. We found the metastatic lymph nodes had no signal reduced intensity or irregular signal reduced intensity on T2-weighted image by using USPIO enhancement. In the tumor group,the sensitivity and specificity of plain MRI were 57.6% and 60.7%. The corresponding values of USPIO-enhanced MRl were 96.1% and 85.7%. (P<0.05)

The features and the extent of the lymph node metastases corresponded to those observed on USPIO-enhanced MR images. USPIO-enhanced MRI is useful for the detection and estimation of lymph node metastasis in this cervical carcinoma animal model.

• Animals
• Cell Line, Tumor
• Dextrans
• Inflammation/pathology
• Lymph Nodes/diagnostic imaging
• Lymph Nodes/pathology
• Lymphatic Metastasis/diagnostic imaging
• Lymphography/methods
• Magnetic Resonance Imaging
• Magnetite Nanoparticles
• Pyriform Sinus/diagnostic imaging
• Pyriform Sinus/pathology
• Rabbits

• Lymph node positivity
• Molecular marker
• Post-treatment rectal cancer
• Tissue microarray

• Aged
• Female
• Humans
• Lymph Nodes/diagnostic imaging
• Lymphatic Metastasis
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neoplasm Invasiveness
• Pelvic Neoplasms/diagnostic imaging
• Pelvic Neoplasms/secondary
• Pelvis/diagnostic imaging
• Rectal Neoplasms/diagnostic imaging
• Sensitivity and Specificity
• Tomography, X-Ray Computed

• MRI
• Rectum
• Tumor

We previously demonstrated that superparamagnetic iron oxide (SPIO)-enhanced MR imaging is promising for the detection of metastases in sentinel nodes localized by CT-lymphography in patients with breast cancer. The purpose of this study was to determine the predictive criteria of the size of nodal metastases with SPIO-enhanced MR imaging in breast cancer, with histopathologic findings as reference standard.

This study included 150 patients with breast cancer. The patterns of SPIO uptake for positive sentinel nodes were classified into three; uniform high-signal intensity, partial high-signal intensity involving ≥50% of the node, and partial high-signal intensity involving <50% of the node. Imaging results were correlated with histopathologic findings.

Thirty-three pathologically positive sentinel nodes from 30 patients were evaluated. High-signal intensity patterns that were uniform or involved ≥50% of the node were observed in 23 nodes that contained macro-metastases and no node that contained micro-metastases, while high-signal intensity patterns involving <50% of the node were observed in 2 nodes that contained macro-metastases and 8 nodes that contained micro-metastases. When the area of high-signal intensity was compared with the pathological size of the metastases, a pathologic >2 mm sentinel node metastases correlated with the area of high-signal intensity, however, a pathologic ≤2 mm sentinel node metastases did not.

High-signal intensity patterns that are uniform or involve ≥50% of the node are features of nodes with macro-metastases. The area of high-signal intensity correlated with the pathological size of metastases for nodes with metastases >2 mm in this series.