Dr Lizzel van der Snee (Netherlands Cancer Institute, Amsterdam, Netherlands), Dr Max Lahaye (Netherlands Cancer Institute, Amsterdam, Netherlands) and Dr Niels Kok (Netherlands Cancer Institute, Amsterdam, Netherlands) discuss the DISCO trial.

In this trial, preoperative diffusion-weighted MRI significantly improved staging accuracy and reduced futile surgical procedures in patients with colorectal peritoneal metastases considered for cytoreductive surgery.

DW-MRI–guided staging lowered the rate of unnecessary operations compared with standard staging (27.4% vs 43.3%, P=0.0093) and reduced the need for staging laparoscopy.

Dr van der Snee highlights the benefit was most pronounced in the Dutch cohort, where laparoscopy was not routinely performed.

These findings support DW-MRI as a valuable addition to preoperative evaluation to better select patients for CRS and minimise avoidable morbidity.