Neoadjuvant chemoradiotherapy (nCRT) is considered one of the treatment modalities of advanced rectal cancer (pT3/T4 or pN+) with the intention of downsizing and downstaging the tumour. Tumour restaging may be useful for planning the operation but tissue alteration after nCRT may disturb the accuracy of the imaging procedures.

Between July 2004 and August 2005, we analysed 28 consecutive patients (18 males, 10 females, ∼63 years) with adenocarcinoma of the middle and distal third of the rectum. High spatial resolution magnet resonance imaging (MRI) with intraluminary contrast and endorectal ultrasonography (EUS) (Olympus EU-M30S, 12 MHz) were performed before and after nCRT as part of their preoperative staging. Radiotherapy was delivered by daily fractions of 1.8 Gy up to a total dose of 50.4 Gy. During days 1–5 and days 29–33 …