Evaluation pitfalls of magnetic resonance imaging on rectal cancer before and after neoadju-vant chemoradiotherapy

Magnetic resonance imaging (MRI) has been the first choice for rectal cancer due to its superb soft tissue resolution. MRI can be used to identify important factors related to treatment and prognosis, including the tumor location, TNM staging, the status of mesorectal fascia, presence of extramural vascular invasion, and involvement of the peritoneal reflection. Clinicians can make optimal surgical planning and determine the need for neoadjuvant therapy according to these factors. Patients who received neoadjuvant therapy need to undergo MRI examination after the completion of therapy with the aim of determining subsequent treatment strategies. The authors review relevant literatures, summarize the limitations and misconceptions of MRI examination in the initial staging of rectal cancer and the re‑staging after neoadjuvant chemoradiotherapy, with the aim of enabling imaging physicians and clinical physicians to fully understand the advantages and limitations of MRI examination for rectal cancer, and applying MRI examination to assist in formulating clinical diagnosis and treatment strategies for rectal cancer.