Functional response imaging following neoadjuvant therapy for rectal cancer

Neoadjuvant therapy has become the standard of care in locally advanced resectable rectal cancer. Increasingly, anti-angiogenic agents are incorporated into neoadjuvant therapy regimens. There is a need for the availability of biomarkers that allow one to select and monitor therapy. Functional imaging using dynamic MRI or PET in combination with mathematical modeling allows the monitoring of early vascular effects of therapy. In parallel, molecular imaging targeting a variety of tumor angiogenesis-associated moieties is under preclinical development. This chapter addresses the rationale, methods, and clinical data related to functional imaging of therapy response in rectal cancer.