Technique of Rectal Cancer MRI and Quality Indicators

Rectal magnetic resonance imaging (MRI) plays a central role in staging, treatment planning, and response assessment in rectal cancer. However, achieving consistent image quality remains challenging in routine practice. This review summarizes key technical aspects of rectal cancer MRI, including patient preparation, image-plane prescription, sequence optimization, and diffusion-weighted imaging. We also propose rectal MRI quality (R-QUAL), a pragmatic quality-assurance framework comprising five domains: tumor location information on the request form, adequacy of T2-weighted image coverage, accuracy of T2-weighted image plane prescription, high-resolution T2-weighted image quality, and diffusion-weighted image quality. Intended for audit, training, and quality-improvement initiatives, R-QUAL provides a structured approach to assessing the technical adequacy of rectal MRI examinations and may support standardization and continuous quality improvement in rectal cancer MRI.