Improving assessment of neoadjuvant treatment in rectal cancer
Research type
Research Study
Full title
RECTIFY - Rectal cancer: Prediction and assessment of neoadjuvant treatment response using functional imaging
IRAS ID
364669
Contact name
Benjamin James Rea
Contact email
Sponsor organisation
University of Sheffield
Duration of Study in the UK
1 years, 5 months, 30 days
Research summary
Locally advanced rectal cancer is usually treated with surgery, sometimes after a course of neoadjuvant treatment to shrink the tumour. In recent years, some patients have been found to respond completely to the neoadjuvant treatment. This has introduced the possibility of organ-preservation approaches such as "watch and wait" strategy. However, to safely offer a non-operative approach, we require highly reliable imaging to detect incomplete response or early tumour recurrence. Current MRI techniques are limited in differentiating between treatment-related changes and residual tumour. This can lead to overstaging after completion of treatment, and not offering a non-operative approach to suitable patients.
This pilot study aims to investigate whether advanced MRI techniques can better predict and monitor the response of rectal cancer to neoadjuvant treatment using perfusion biomarkers. We will also explore the potential role of photon-counting CT, a newer imaging technique in assessing response and monitoring of treatment in rectal cancer.
We plan to recruit up to 20 adults with histologically confirmed locally advanced rectal cancer, who are already scheduled to receive neoadjuvant therapy by their clinicians. After providing informed consent, participants will undergo baseline MRI scans before starting treatment. Their response to treatment will be evaluated at routine clinical time points. These scheduled scans will include additional MRI sequences as a part of this research. Photon-counting CT will be utilised during routine follow-up imaging in the surveillance period. No additional hospital visits beyond standard care are anticipated after starting treatment.
By combining novel functional MRI measures with photon-counting CT metrics, this study aims to improve the
accuracy of post-neoadjuvant treatment response assessment. The findings may help refine surveillance strategies and support safer patient selection for organ-preservation management in the future.REC name
London - Surrey Research Ethics Committee
REC reference
26/PR/0277
Date of REC Opinion
26 Mar 2026
REC opinion
Further Information Favourable Opinion