New Updates in Diagnostic Imaging and Treatment of Rectal Cancer

Colorectal cancer (CRC) is the third most common tumour in men and the second most common in women. It ranks as the third leading cause of new cancer cases and cancer-related deaths in both sexes. Due to differences in embryonic origin, rectal cancer (RC) is considered a distinct entity from colon cancer in terms of staging and treatment. Mortality rates in more developed countries are decreasing, largely due to increased screening and advances in the staging and treatment of rectal cancer. Current screening methods include faecal occult blood testing (FOBT) and rectosigmoidoscopy. For staging, the most commonly used imaging modalities are abdominopelvic magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) for locoregional evaluation, and computed tomography (CT), MRI, or positron emission tomography (PET) for detecting distant metastases. Traditionally, the standard treatment for rectal cancer has been total mesorectal excision. However, more recently, it has been observed that patients with non-advanced stages of the disease may benefit from neoadjuvant radiochemotherapy, which can allow for less invasive surgery at a later stage. In recent years, radiomic studies have emerged to identify predictive features of tumour progression, with the goal of personalising treatment according to each patient’s characteristics.