MRI technique reduces low-value surgeries for patients with colorectal cancer
A specialized MRI technique could help patients with colorectal peritoneal metastases avoid unnecessary surgery, according to data set to be presented at the 2026 American Society of Clinical Oncology Gastrointestinal Cancers Symposium.
For patients with these metastases, cytoreductive surgery is a current standard-of-care option for prolonging survival. Though effective, the surgery is accompanied by a high risk of major morbidity, making the decision to undergo the procedure complex for many patients.
New research suggests that diffusion-weighted MRI could help providers determine which patients are most likely to benefit from the surgery and spare those at risk of complications from having to undergo a futile procedure. DW-MRI provides insight into how water moves through tissues. In tumors, this flow is restricted, making DW-MRI a promising option for individuals with colorectal peritoneal metastases because it gives providers greater visualization of a tumor’s extent. This allows for more accurate disease staging.
“Accurate staging is crucial to identify who is most likely to benefit from [cytoreductive surgery]. Computed tomography often underestimates the extent of disease, necessitating additional staging laparoscopy,” lead study author Lizzel van der Snee, MD, of the Netherlands Cancer Institute, and colleagues noted in the study’s abstract.
The DISCO study included 277 patients who were randomized to either a DW-MRI–based staging group or a standard staging group with or without a staging laparoscopy. Researchers used data on the extent of a patient’s disease, surgical procedures and outcomes to weigh the effect of using DW-MRI over standard staging tactics.
The team observed a substantial decrease in staging laparoscopies in the DW-MRI group (30.6% v 55.8%). The DW-MRI group also underwent fewer futile surgical procedures, at 26.8% compared to 42.5% in the control group, representing a 15.7% decrease.
The findings are promising, but additional research in larger cohorts is needed before this protocol can be clinically implemented. The team has received additional funding and has plans to work with other hospitals to help them better understand the options for their patients.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.