Fig. 6
From: Role of diffusion-weighted MRI in diagnosis and post therapeutic follow-up of colorectal cancer
A 69-year-old male presented with constipation, bleeding per rectum, and hematuria (colonoscopy and biopsy revealed sigmoid colon mucinous type adenocarcinoma). Pretreatment study (A to E) revealed large lobulated soft tissue mass infiltrating the sigmoid colon with large exophytic component invading the urinary bladder (measured 10 × 7.9 × 13.3 cm). It displayed heterogeneous high signal in T2WI (A) and low to intermediate signal in T1WI (B), with heterogeneous enhancement in post contrast images (C). The lesion appeared bright in DWIs (D) and relatively bright in the ADC map (E), with ADC value 1.6 × 10−3 mm2/s, indicating predominantly facilitated diffusion. Posttreatment study after chemo and radiotherapy (F to J) revealed stationary course regarding the size and signal of the mass and displayed heterogeneous high signal in T2WI (F) and low to intermediate signal in T1WI (G), with less prominent enhancement centrally in post contrast images (H). The lesion appeared bright in DWIs (I) and predominantly bright in the ADC map (J), with ADC value 1.8 × 10−3 mm2/s, indicating facilitated diffusion. Colonoscopy and biopsy revealed residual tumor cells of mucinous adenocarcinoma