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The Royal Marsden
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Philosophy of avoiding APE surgery if patient has had a good
response to treatment
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mrTRG 1-3 - used to identify patients suitable for deferral (many
are falsely positive on biopsy, DWI and PET-CT)
MRI reassessment after CRT
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Serial imaging – decision for deferral is not based on a single scan
– uses the advantage of high resolution MRI monitoring
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Employing serial MRI monitoring - gives opportunity to delay
surgery until there is evidence of tumour regrowth rather than
biopsy of tumour cells which are of uncertain viability