Post-radiation levator ani atrophy is associated with worse Low Anterior Resection Syndrome score after nonoperative management for locally advanced rectal cancer: a potential MRI biomarker

Decrease in 2D measurements of the levator ani from pre-treatment to 1-year post-radiation is correlated with higher LARS scores, indicating worse bowel function, perhaps due to radiation fibrosis and atrophy. This imaging biomarker may help to identify patients who could most benefit from pelvic floor physical therapy interventions. Further studies with larger cohorts are required to validate these findings.