Recurrent rectal cancer: diagnosis with MR imaging versus CT

During an 18-month period, a prospective study comparing the findings at computed tomography (CT) and magnetic resonance (MR) imaging was conducted on 35 patients who satisfied the following criteria: prior surgery for rectal cancer (11 curative resections, 24 rectal amputations), perineal pain and/or elevated carcinoembryonic antigen (CEA) level, and a soft-tissue mass in the presacral fossa demonstrated at CT. Twenty-two patients had tumor recurrence; 13 patients had only inflammatory changes or radiation fibrosis. At a single examination of each patient (with no reference to prior baseline studies), MR imaging was more accurate than CT, largely because MR imaging was more successful in the distinction of recurrence from fibrosis based on the differences in signal intensity on T2-weighted images.