Extramural venous invasion (EMVI) in Rectal cancer is an independent predictor of local and distant recurrence, nodal disease and overall survival. Accurate preoperative EMVI detection has implications for treatment decisions. Previously, MRI has been evaluated for this purpose previously against histopathology with Hematoxylin-Eosin(HE) staining. Recently histopathology with Elastin stain has been recommended for EMVI detection given its 2-3-fold increase in accuracy and improved prognostication compared to HE stain. The diagnostic performance of MRI for EMVI detection compared to elastin stain based histopathology is unknown and in this study, we present our results to address this issue.
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