The pelvis after surgery and radio-chemotherapy for rectal cancer studied with Gd-DTPA-enhanced fast dynamic MR imaging.

The aim of this work was to study the gadolinium-enhancement of malignant and benign pathology in the pelvis after surgery for rectal cancer. Thirty patients with either local recurrence (n = 17) or benign changes related to treatment for rectal cancer (n = 13) were studied with pelvic MR imaging. T2-weighted fast spin-echo as well as T1-weighted spin- or gradient-echo imaging before and after intravenous contrast was performed and referred to as contrast-enhanced MRI (CEMRI). In addition, between the pre- and postcontrast images, dynamic contrast-enhanced MRI (DCEMRI) was performed using a single-slice, multi-phase, contrast-enhanced T1-weighted fast spoiled gradient-echo sequence. The time between the start of contrast injection to the beginning of enhancement, the duration and rate of enhancement as well as enhancement amplitude were recorded. The data were compared with the clinical diagnosis according to biopsy in 8 patients and surgery in 6 patients. In the remaining 16 patients, the clinical diagnosis was obtained by clinical or radiological follow-up. DCEMRI did not improve the diagnostic information compared with CEMRI. None of the examined parameters were found to help discriminating malignant from benign changes. Characterisation of lesions in the pelvis after rectal cancer surgery was not improved by a dynamic gadolinium-enhanced sequence.