Lower GI 2017

The Royal Marsden

• Philosophy of avoiding APE surgery if patient has had a good response to treatment MRI reassessment after CRT

• mrTRG 1-3 - used to identify patients suitable for deferral (many are falsely positive on biopsy, DWI and PET-CT)

• Serial imaging – decision for deferral is not based on a single scan – uses the advantage of high resolution MRI monitoring

• Employing serial MRI monitoring - gives opportunity to delay surgery until there is evidence of tumour regrowth rather than biopsy of tumour cells which are of uncertain viability