Colorectal cancer: Current imaging methods and future perspectives for the diagnosis, staging and therapeutic response evaluation
Colorectal cancer: Current imaging methods and future perspectives for the diagnosis, staging and therapeutic response evaluation
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DOI：
10.3748/wjg.v19.i46.8502
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发表时间：
2013-12-14
影响因子：
4.3
通讯作者：
Hohmann, Joachim
中科院分区：
文献类型：
--
作者：
Kekelidze, Maka;D'Errico, Luigia;Hohmann, Joachim
在过去 10 年中，由于诊断技术的不断发展以及手术、新辅助和姑息治疗的优化，结直肠癌 (CRC) 的死亡率下降了 20% 以上。目前用于评估 CRC 的诊断方法多种多样，并且在不同国家和机构之间可能有所不同。本文旨在深入讨论目前在结直肠癌诊断中应用的成像方式，如虚拟计算机断层扫描结肠镜检查、直肠内超声、计算机断层扫描（CT）和磁共振成像（MRI）。特别关注最近诊断发展的潜力，如扩散加权成像 MRI、MRI 生物标志物（动态增强 MRI）、2-(氟-18)-氟-2-脱氧-D-葡萄糖正电子发射断层扫描 (FDG-PET) 结合计算机断层扫描 (PET/CT) 和新型肝胆 MRI 造影剂。这些方式的确切作用、优点和缺点在 CRC 的局部分期、转移扩散和治疗监测中的评估存在争议。最后，作者将探讨功能成像的未来前景，评估集成 FDG-PET/CT 与灌注 CT、原发性 CRC MRI 光谱以及使用对比增强超声和 MRI 进行肝脏传输时间分析在肝转移检测中的作用。这些更新的成像技术的验证可能会显着改善结直肠癌患者的治疗。 (C) 2013 百事登出版集团有限公司。版权所有。
In the last 10 years the mortality rate of colorectal cancer (CRC) has decreased by more than 20% due to the rising developments in diagnostic techniques and optimization of surgical, neoadjuvant and palliative therapies. Diagnostic methods currently used in the evaluation of CRC are heterogeneous and can vary within the countries and the institutions. This article aims to discuss in depth currently applied imaging modalities such as virtual computed tomography colonoscopy, endorectal ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of CRC. Special focus is put on the potential of recent diagnostic developments as diffusion weighted imaging MRI, MRI biomarkers (dynamic enhanced MRI), positron emission tomography with 2-(fluorine-18)-fluoro-2-deoxy-D-glucose (FDG-PET) combined with computed tomography (PET/CT) and new hepatobiliary MRI contrast agents. The precise role, advantage and disadvantages of these modalities are evaluated controversially in local staging, metastatic spread and treatment monitoring of CRC. Finally, the authors will touch upon the future perspectives in functional imaging evaluating the role of integrated FDG-PET/CT with perfusion CT, MRI spectroscopy of primary CRC and hepatic transit time analysis using contrast enhanced ultrasound and MRI in the detection of liver metastases. Validation of these newer imaging techniques may lead to significant improvements in the management of patients with colorectal cancer. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.