Consensus statement EURECCA consensus conference highlights about colon & rectal cancer multidisciplinary management: The radiology experts review V. Tudyka a , L. Blomqvist b , R.G.H. Beets-Tan c , P.G. Boelens d , V. Valentini e , C.J. van de Velde f , A. Dieguez g , G. Brown a, * a Department of Radiology, The Royal Marsden NHS Foundation Trust, Fulham Road, London, UK b European Society of Radiology, Department of Diagnostic Radiology, Karolinska University Hospital, Stockholm, Sweden c European Society of Radiology, Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands d Scientific Board CC3, Department of Surgery, Leiden University Medical Center, The Netherlands e Executive Committee CC3, European Society for Radiotherapy and Oncology (ESTRO), Department of Radiation Oncology, Universit a Cattolica S. Cuore, Rome, Italy f Executive Board of ECCO, European Society of Surgical Oncology (ESSO), Department of Surgery, Leiden University Medical center, The Netherlands g Diagn ostico M edico, Jun ın 1023, Ciudad Aut onoma de Buenos Aires, Argentina Accepted 23 October 2013 Available online 14 December 2013 Abstract Some interesting shifts have taken place in the diagnostic approach for detection of colorectal lesions over the past decade. This article accompanies the recent EURECCA consensus group reccomendations for optimal management of colon and rectal cancers. In summary, imaging has a crucial role to play in the diagnosis, staging assessment and follow up of patients with colon and rectal cancer. Recent ad- vances include the use of CT colonography instead of Barium Enema in the diagnosis of colonoic cancer and as an alternative to colonos- copy. Modern mutlidetector CT scanning techniques have also shown improvements in prognostic stratification of patients with colonic cancer and clinical trials are underway testing the selective use of neoadjuvant therapy for imaging identified high risk colon cancers. In rectal cancer, high resolution MRI with a voxel size less or equal to 3  1  1 mm3 on T2-weighted images has a proven ability to accurately stage patients with rectal cancer. Moreover, preoperative identification of prognostic features allows stratification of patients into different prognostic groups based on assessment of depth of extramural spread, relationship of the tumour edge to the mesorectal fascia (MRF) and extramural venous invasion (EMVI). These poor prognostic features predict an increased risk of local recurrence and/or met- astatic disease and should form the basis for preoperative local staging and multidisciplinary preoperative discussion of patient treatment options. Ó 2013 Published by Elsevier Ltd. Keywords: Consensus; Guidelines; Colon cancer; Rectal cancer Introduction Although the management of rectal and colon has under- gone significant advances in recent years, there is still het- erogeneity in clinical outcomes as well as variations in treatment strategies. The European Registration of Cancer * Corresponding author. Dr Gina Brown, The Royal Marsden NHS Foun- dation Trust, Downs Road Sutton Surrey, SM2 5PT, United Kingdom. Tel.: þ44 208 6613964; fax: þ44 208 915 6721. E-mail addresses: P.G.Boelens@lumc.nl (P.G. Boelens), gina.brown@ rmh.nhs.uk (G. Brown). 0748-7983/$ - see front matter Ó 2013 Published by Elsevier Ltd. http://dx.doi.org/10.1016/j.ejso.2013.10.029 Available online at www.sciencedirect.com ScienceDirect EJSO 40 (2014) 469e475 www.ejso.com