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This study is testing new imaging and analysis methods to improve how doctors predict treatment response in rectal cancer patients receiving chemoradiotherapy. Current MRI scans sometimes miss complete tumor response, which can lead to unnecessary surgery. To address this, researchers will use a special MRI technique called hyperpolarized carbon-13 MRI, along with blood and tissue analysis (metabolomics) and advanced image feature analysis (radiomics). These tools can track how cancer cells use energy and how metabolism changes during treatment. The study will follow 30 rectal cancer patients at Chang Gung Memorial Hospital over 3 years. Patients will undergo standard MRI, colonoscopy, and advanced metabolic imaging before and after treatment. Results will compare patients whose tumors completely respond to therapy with those who do not. The goal is to see if metabolic changes detected
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