← Issue №5/ week of Aug 2, 2026/Colorectal

A simple MRI/PET-derived index predicts relapse-free survival after neoadjuvant chemoradiotherapy in locally advanced rectal cancer.

From GI Signals issue №5: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Colorectal retrospective · n=68 · Aug 1, 2026 · Colorectal Disease · IF 3.2

A simple MRI/PET-derived index predicts relapse-free survival after neoadjuvant chemoradiotherapy in locally advanced rectal cancer.

Diagnosticbiomarkercolorectal cancerartificial intelligence
Clinical takeawayConsider using the T/S ratio (tumor area/SUVmax) from pretreatment MRI/PET-CT to stratify risk and guide individualized neoadjuvant strategies in locally advanced rectal cancer.
What it foundPatients with a high T/S ratio (cut-off 55.81) had significantly poorer 3-year relapse-free survival (51.8% vs. 84.0%, p = 0.002).
ContextThis study introduces a novel imaging biomarker that refines risk stratification in locally advanced rectal cancer, addressing a gap in pretreatment prognostic tools.
Measured against the standard of care· USMSTF 2017 (Rex et al., Gastroenterology) + USMSTF 2022 focused update on age (Patel et al., Gastroenterology 2022;162:285-299) / ACS 2026 (CA Cancer J Clin)

Decision at stakepredicting response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer

No single passage of this standard matched the paper closely enough to quote, so none is shown. The standard is cited above.

Our full summary of this standard

U.S. Multi-Society Task Force (2017 guideline, revised by the 2022 focused update on age to start and stop): offer average-risk colorectal cancer screening to everyone aged 45-75. Screening at 45-49 is a weaker recommendation than at 50-75. Colonoscopy every 10 years and annual FIT are the Tier 1 cornerstones. Tier 2 alternatives are multi-target stool DNA every 3 years, CT colonography every 5 years, and flexible sigmoidoscopy every 5-10 years. Capsule colonoscopy every 5 years is Tier 3. Any abnormal non-colonoscopy test requires a diagnostic colonoscopy, and a stool test should not be offered to a patient who would decline follow-up colonoscopy. Patients who are up to date with negative prior screening, particularly a high-quality colonoscopy, may consider stopping at 75 or when life expectancy is under 10 years. Decisions at 76-85 are individualized by health and prior screening, and screening after 85 is not recommended. The American Cancer Society's May 2026 guideline agrees on the 45-75 range, no screening after 85, and colonoscopy as the preferred option. It adds the next-generation mt-sDNA test and the multitarget stool RNA test (ColoSense), both every 3 years, and it adds an FDA-approved blood-based cfDNA test (Shield) only for people who decline or do not complete visual or stool screening. ACS says a positive stool or blood test should be followed by colonoscopy, preferably within 6 months. The 2026 ASGE paper on follow-up after an abnormal stool test is an implementation review (navigation, tracking, direct-access colonoscopy), not a new screening guideline.

USMSTF 2017 (Rex et al., Gastroenterology) + USMSTF 2022 focused update on age (Patel et al., Gastroenterology 2022;162:285-299) / ACS 2026 (CA Cancer J Clin) · reviewed 2026-10-11 ↗
Shioi I … Saeki H · Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland · IF 3.2 · PubMed ↗Permalink
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