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. 2016 Jul 18;3:145–152. doi: 10.1016/j.ejro.2016.06.003

Fig. 4.

Fig. 4

Stable disease. MR images of a 77-year old man classified as stable disease both on combined set of conventional and DW images and on T2-weighted images. (a) Pre-CRT axial T2-weighted image shows neoplastic tissue in the middle rectum (white arrow) with nodal involvement (white arrowhead). The tumor has spread into the mesorectal fat for more than 10 mm (T3c N1 stage). (b) Pre-CRT DW (b = 800 s/mm2) image shows high signal intensity area due to neoplastic tissue (white arrows). (c) Pre-CRT ADC map at the same level shows low signal intensity area (white arrow). The mean ADC value was 0.937 × 10−3 s/mm2. (d) Post-CRT axial T2-weighted image shows a poor tumor reduction with persistence of neoplastic spread (white arrow) into the mesorectal fat (T3 stage). (e) Post-CRT DW (b = 800 s/mm2) image shows high signal intensity area in the corresponding tumor (white arrows). (f) Post-CRT ADC map at the same level shows low signal intensity area (white arrow). (g) Photomicrograph (H&E x600). Poor regression (TRG: 0 + 1), predominance of areas with tumor remnants surrounded by a poor fibrous reaction induced by the treatment.