Classification of response after neoadjuvant chemoradiotherapy for rectal cancer

	Complete response	Near complete response	Incomplete response
Endoscopy	Flat, white scar Telangiectasia No ulcer No nodularity	Irregular mucosa Small mucosal nodules or minor mucosal abnormality Superficial ulceration Mild persisting erythema of the scar	Visible tumor
Digital rectal exam	Normal	Smooth induration or minor mucosal abnormalities	Palpable tumor nodules
MRI-T2W	Only dark T2 signal, no intermediate T2 signal AND No visible lymph nodes	Mostly dark T2 signal, some remaining intermediate signal AND/OR Partial regression of lymph nodes	More intermediate than dark T2 signal, no T2 scar AND/OR No regression of lymph nodes
MRI-DW	No visible tumor on B800-B1000 signal AND/OR Lack of or low signal on ADC map Uniform, linear signal in wall above tumor is OK	Significant regression of signal on B800-B1000 AND/OR Minimal or low residual signal on ADC map	Insignificant regression of signal on B800-B1000 AND/OR Obvious low signal on ADC map

MRI-T2W: T2-weighted magnetic resonance imaging; MRI-DW: diffusion-weighted magnetic resonance imaging; ADC: apparent diffusion coefficient.

From: Smith JJ, Chow OS, Gollub MJ, et al. Organ preservation in rectal adenocarcinoma: a phase II randomized controlled trial evaluating 3-year disease-free survival in patients with locally advanced rectal cancer treated with chemoradiation plus induction or consolidation chemotherapy, and total mesorectal excision or nonoperative management. BMC Cancer 2015; 15:767. Available at: https://bmccancer.biomedcentral.com/articles/10.1186/s12885-015-1632-z (Accessed on August 6, 2020). Copyright © The Authors. Reproduced under the terms of the Creative Commons Attribution License 4.0.

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Classification of response after neoadjuvant chemoradiotherapy for rectal cancer