Learning Objectives
1. Up to a third of rectal cancers undergoing chemoradiotherapy may achieve complete regression so that post-treatment MRI may save them from surgery.
2. The radiologist must increasingly understand the regression process and timing of the replacement of cancer by scar tissue.
3. Tumour regression grading (TRG) and its relationship to endoscopic and histological criteria must be understood. A new sign, the split scar (SSS), may be a predictor of the permanence of the regression.