Female 43 years old Reason: Please follow protocol IRB # 14-0288. Rectal cancer, please assess disease state post Chemo, RECIST compare to previous MRI. Overall image quality: GoodPELVIS:UTERUS, ADNEXA: The rectal mass continues to abut the posterior cervix (image 41/series 6), suspicious for invasion.BLADDER: No significant abnormality noted. LYMPH NODES: Lymph nodes in the perirectal space, within the mesorectal fascia: None.Lymph nodes outside the mesorectal fascia: None.BOWEL, MESENTERY: Rectal Tumor:Size: 1.4 x 2.0 x 7.1 cm (image 41/series 6) (image 24/series 10)Tumor appearance on T2-weighted images: Circumferential tumor with large soft tissue component along the left aspect of the rectum.Tumor location: Extending from the anal verge 7.1 cm proximally, involving the rectum to the distalmost sigmoid colon.(For lower rectal tumors):Distance of the lower edge of the tumor to the anal verge (lower edge of the anal canal): 2.0 cmDistance of the lower edge of the tumor to the pelvic floor (relationship of the tumor to the anal sphincter complex): Extends from the anal sphincter proximally.Circumference of the rectum involved: Complete circumferential distally but proximally occupies 180 degrees along the left aspect.Relationship and proximity of the tumor to adjacent structures (uterus, cervix, vagina): There is invasion of the adjacent mesorectal fat and fascia as well as invasion into the posterior wall of the upper vagina and cervix (image 41/series 6) (image 22/series 10).MRI T-stage: T4 - Tumor invades adjacent organs, as described aboveTumor Distance to Mesorectal Fascia: 0 cm (image 22/series 10).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of free fluid, likely physiologic and similar to prior.
1.Decreased size and extent of the circumferential rectal adenocarcinoma, with continued invasion of adjacent vagina and cervix.2.No lymphadenopathy.