ObjectiveTo summarize the current status and progress of MR imaging in field of rectal cancer.MethodsThe recent literatures on this topic were reviewed and analyzed, then the key information they provide was integrated.ResultsBesides its measurement of tumor height and length, the MR imaging was also significant in the preoperative assessments of tumor staging and prognostic factors such as the extramural vascular invasion (EMVI), circumferential resection margin (CRM), and perineural invasion (PNI). However, some drawbacks couldn’t be neglected. For instance, the conventional MR imaging was of limited use in discriminating T1, T2 and borderline T3 rectal cancer. The similar limitation applies to situation between T3 and T4a rectal cancer as well. And its performances in the N staging prior to and post-neoadjuvant chemoradiation therapy were just average. Currently the functional MR imaging like the diffusion weighted imaging (DWI), some relatively novel modalities such as the dynamic contrast enhanced MRI and chemical shift have served in the radiological diagnosis of the rectal cancer.ConclusionsMR imaging is the most frequently used modality in preoperative assessment of rectal cancer. It can describe size and location of tumor, assist in tumor staging, and evaluate prognostic factors. And it is supposed to provide critical information on decision making and prognosis judging. Besides current value of conventional MR imaging in the field of rectal cancer, some innovative techniques have shown moderate potentials as well. Due to their promising future use, detection of new biomarkers regarding rectal cancer can be expected.
ObjectiveTo summarize the current status and update of the use of medical imaging in risk prediction of pancreatic fistula following pancreaticoduodenectomy (PD).MethodA systematic review was performed based on recent literatures regarding the radiological risk factors and risk prediction of pancreatic fistula following PD.ResultsThe risk prediction of pancreatic fistula following PD included preoperative, intraoperative, and postoperative aspects. Visceral obesity was the independent risk factor for clinically relevant postoperative pancreatic fistula (CR-POPF). Radiographically determined sarcopenia had no significant predictive value on CR-POPF. Smaller pancreatic duct diameter and softer pancreatic texture were associated with higher incidence of pancreatic fistula. Besides the surgeons’ subjective intraoperative perception, quantitative assessment of the pancreatic texture based on medical imaging had been reported as well. In addition, the postoperative laboratory results such as drain amylase and serum lipase level on postoperative day 1 could also be used for the evaluation of the risk of pancreatic fistula.ConclusionsRisk prediction of pancreatic fistula following PD has considerable clinical significance, it leads to early identification and early intervention of the risk factors for pancreatic fistula. Medical imaging plays an important role in this field. Results from relevant studies could be used to optimize individualized perioperative management of patients undergoing PD.