{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T01:48:09Z","timestamp":1783648089102,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T00:00:00Z","timestamp":1637625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Rectal neuroendocrine tumours (NETs) are the most common type of gastrointestinal NET. European Neuroendocrine Tumour Society guidelines suggest that rectal NETs measuring \u226410\u00a0mm are indolent with low risk of spread. In practice, many patients with lesions \u22641\u00a0cm do not undergo complete tumour staging. However, the size of the lesion may not be the only risk factor for nodal involvement\/metastases. The aim of this study was to determine if MRI\u00a0\u00b1\u00a0nuclear medicine imaging alters tumour stage in patients with rectal NETs \u226410\u00a0mm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients referred to a tertiary NET centre between 2005 and 2020 who met the inclusion criteria of a rectal NET \u226410\u00a0mm, full cross\u2010sectional imaging, primarily an MRI scan and, if abnormal findings were identified, a subsequent <jats:sup>68<\/jats:sup>Ga\u2010DOTATATE positron emission tomography scan were included. All patients were followed up at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 32 patients with rectal NETs 10\u00a0mm or less were included in the study: 16 women; median age 58\u00a0years (range 33\u201371); 47% (<jats:italic>n<\/jats:italic>\u00a0=\u00a015) were referred from bowel cancer screening procedures. The median size of the lesions was 5\u00a0mm (range 2\u201310\u00a0mm). 81% (<jats:italic>n<\/jats:italic>\u00a0=\u00a026) were World Health Organization Grade 1 tumours with Ki67 &lt;3%. Radiological staging confirmed nodal involvement in 25% (8\/32); two cases had distant metastatic disease. Lymphovascular invasion was present in 3% (1\/32) of patients but none demonstrated peri\u2010neural invasion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates that small rectal NETs can develop nodal metastases; therefore it is important to stage these tumours accurately with MRI at baseline and, if there are concerns regarding potential lymph node metastases, to consider <jats:sup>68<\/jats:sup>Ga\u2010DOTATATE positron emission tomography imaging.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15978","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T18:03:38Z","timestamp":1635962618000},"page":"3173-3179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Nodal metastases in small rectal neuroendocrine tumours"],"prefix":"10.1111","volume":"23","author":[{"given":"Sarah","family":"O\u2019Neill","sequence":"first","affiliation":[{"name":"Neuroendocrine Tumour Unit ENETS Centre of Excellence Kings College Hospital  London UK"},{"name":"Department of Gastroenterology Kings College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amyn","family":"Haji","sequence":"additional","affiliation":[{"name":"Department of Surgery Kings College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Radiology Kings College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Clement","sequence":"additional","affiliation":[{"name":"Neuroendocrine Tumour Unit ENETS Centre of Excellence Kings College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Sarras","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kings College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bu","family":"Hayee","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kings College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Mulholland","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Kings College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John K.","family":"Ramage","sequence":"additional","affiliation":[{"name":"Neuroendocrine Tumour Unit ENETS Centre of Excellence Kings College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajaventhan","family":"Srirajaskanthan","sequence":"additional","affiliation":[{"name":"Neuroendocrine Tumour Unit ENETS Centre of Excellence Kings College Hospital  London UK"},{"name":"Department of Gastroenterology Kings College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2010.12.005"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-019-0606-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.0589"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14033"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11105"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335594"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000443166"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3181ec1261"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.5603\/EP.2017.0019"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13697"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12112512"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20939"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640619861883"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3393\/jksc.2011.27.1.17"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2012.07218.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.109157"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2017.134"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-014-3430-0"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpge.2015.04.008"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-010-0949-y"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.341"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2013.01.007"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15978","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.15978","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15978","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T07:58:57Z","timestamp":1693209537000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.15978"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,23]]},"references-count":22,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1111\/codi.15978"],"URL":"https:\/\/doi.org\/10.1111\/codi.15978","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,23]]},"assertion":[{"value":"2021-02-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}