EP1007 - Multidisciplinary Tumor Board MRI Re-interpretation in Rectal Cancer: Effects on T-, N-, and AJCC Stage Migration

Monday, May 11, 2026

4:08 PM - 4:13 PM ET

ePoster Presenter(s)

Seth Felder, MD

Associate Member, Department of Gastrointestinal Oncology
Moffitt Cancer Center
Moffitt Cancer Center
Tampa, FL, United States

Disclosure information not submitted.

Author(s)

Torrin Jacobsen, MS

Research Associate
Moffitt Cancer Center
LECOM-Bradenton
Tampa, FL, United States

Disclosure information not submitted.

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Author(s)

Amalia Stefanou, MD MAS (she/her/hers)

Associate Member
Moffitt Cancer Center
Moffitt Cancer Center
Tampa, FL, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose
SD

Sophie Dessureault, MD, PhD

Senior Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
Julian Sanchez, MD (he/him/his)

Senior Member, Department of Gastrointestinal Oncology
Moffitt Cancer Center
Moffitt Cancer Center
Tampa, FL, US

Disclosure information not submitted.
SH

Sarah Hoffe, n/a

Senior Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
JF

Jessica Frakes, n/a

Associate Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
HH

Hope Hahl, n/a

Nurse Practitioner
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
II

Iman Imanirad, n/a

Senior Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
SM

Satish Maharaj, n/a

Assistant Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
AL

Allan Lima Perreira, n/a

Associate Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
TB

Tiago Biachi de Castria, n/a

Associate Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
RK

Richard Kim, n/a

Research Associate
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
JE

Jennifer Eatrides, n/a

Associate Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
MW

Megan Winter, n/a

Assistant Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
MS

Maria Sandoval, n/a

Associate Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
LS

Larry Silverman, n/a

Senior Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
SD

Sarah Dooley, n/a

Assistant Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
RP

Raj Mohan Paspulati, MD

Senior Member, Diagnostic Imaging
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
JC

James Costello, MD, PhD

Associate Member, Diagnostic Imaging
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
CA

Cyrillo Araujo, n/a

Senior Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
SF

Sebastian Feuerlein, n/a

Senior Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
EW

Eloise Wein, n/a

Research Associate
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
SG

Sarah Goodchild, BS

Disclosure information not submitted.
JS

Jordan Strauss, n/a

Research Associate
Florida Atlantic University AD Henderson University School
Boca Raton, Florida, United States

Disclosure information not submitted.
NR

Natali Ronen, n/a

Assistant Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
GL

Gregory Lauwers, n/a

Senior Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.
SC

Saras Cappelle, n/a

Associate Member
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.

Senior Author(s)

HV

Harshna Vadvala, MD

Assistant Member, Diagnostic Imaging
Moffitt Cancer Center
Tampa, Florida, United States

Disclosure information not submitted.

Purpose/Background: High-resolution rectal MRI drives stage-based therapy. Multidisciplinary Tumor Board (MDTB) MRI reinterpretation may reduce over- and under-treatment by optimizing local staging. We quantified MDTB-related mrT/mrN changes, AJCC stage migration, and potential management impact, and compared externally acquired vs internal MRIs.

Methods/Interventions: Single center prospectively maintained registry was retrospectively analyzed. Consecutive, newly diagnosed rectal adenocarcinoma patients discussed at a Rectal Cancer MDTB (July 2024-July 2025). The initial radiology report was compared with the MDTB MRI reinterpretation for mrT (T1-4; T3a-d, T4a/b), mrN (N−/N+), and AJCC 8th ed. stage. The primary endpoint was any mrT and/or mrN change with or without AJCC migration, and the secondary endpoint was the proportion that MDTB reinterpretation altered intended management per institutional pathways. . MRIs at the MDTB were interpreted by dedicated rectal MRI radiologists in consensus with colorectal surgical, medical, and radiation oncologists. External (outside) vs internal MRIs were compared. Fisher's exact test and odds ratios (OR) with 95% CIs reported (α=0.05). Analyses were performed in R.

Results/Outcomes: Among 102 patients (mean age 64.4 years; 40.2% female), 60 (58.8%) had internal and 42 (41.2%) external MRIs. MDTB reinterpretation produced mrT change in 31.4% (32/102), mrN change in 15.7% (16/102), and AJCC migration in 15.7% (16/102); any mrT and/or mrN change occurred in 39.2% (40/102). External MRIs had higher odds of mrT change than internal (45.2% vs 21.7%; OR 2.95, 95% CI 1.16-7.78; p=0.02). mrN change, AJCC migration, and management-impact rates did not differ significantly by MRI source. Among patients with any mrT/mrN change and non-metastatic disease (n=34), MDTB reinterpretation influenced treatment decision in 82.4% (28/34) of patients, 27.5% for the entire cohort.

Conclusion/Discussion: Rectal cancer MRI interpretation is critical for local tumor staging, determining treatment approach, and prognosis. Routine rectal cancer MDTB MRI reinterpretation frequently changes locoregional T/N staging (~39%) and may influence treatment approach (~28%). Externally acquired MRIs were ~3-fold more likely to undergo mrT revision at MDTB. Systematic rectal MRI staging through a MDTB may improve quality and outcomes.

Figure 1: Sankey diagram of MDTB MRI T-, N- Changes and Influence on Treatment