2026 Global Exchange Course: Rectal MRI

RANZCR Course Director: Kirsten Gormly
ARRS Course Director: Aliya Qayyum

MRI of rectal cancer has increased in importance over the past decade and it is essential radiologists are aware of the updated methods of assessment. MRI is considered standard of care for primary staging. This provides accurate T staging and detection of poor prognostic factors such as mesorectal fascia involvement and extra mural venous invasion. The traditional difficulties surrounding N staging are being overshadowed by the improved ability to identify the more clinically significant tumour deposits (TD).

The increased use of total neoadjuvant therapy (TNT) with high rates of complete clinical response have led to a significant proportion of patients requiring post TNT MRI assessment monitoring. The radiologist must be able to accurately identify any residual tumour, with varying methods proposed around the world. The most widespread and validated global method currently remains MR Tumour regression Grade (mrTRG), with evolving prognostic evidence for the ‘split scar sign’.

Australian and New Zealand radiologists have been at the forefront of rectal MRI since 2004, due to early and ongoing collaboration with one of the global leaders in rectal MRI, Prof Gina Brown from London. Dr. Kirsten Gormly is a well-respected national and international lecturer, including presenting in the US Society of Abdominal Radiology (SAR) opening plenary session on ‘Global variations in rectal MRI’ in Feb 2020, and at the European Society of Gastrointestinal Abdominal Radiology (ESGAR) annual meetings. She leads the Abdominal Radiology Group of Australia and New Zealand (ARGANZ) rectal focus group and has recently joined the SAR anorectal disease focussed panel (DFP). Dr. Verity Wood had given many lectures in Australia and New Zealand and is a member of the ARGANZ rectal focus group.