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Imaging as a surveillance tool in rectal cancer
Massimo Bellomi1, Laura Lavinia Travaini
1Department of Radiology and School of Medicine, University of Milano, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. massimo.bellomi@ieo.it
Expert Review of Medical Devices
|December 22, 2009
Summary
Recurrent rectal cancer remains a major challenge. This review examines imaging techniques for detecting recurrence, highlighting MRI for pelvic and liver imaging and suggesting future whole-body MRI for comprehensive screening.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Rectal cancer recurrence significantly impacts patient survival despite treatment advances.
- Current intensive surveillance programs show no proven survival benefit for early recurrence detection.
Purpose of the Study:
- To review and compare the diagnostic performance of various imaging techniques for rectal cancer recurrence.
- To discuss the clinical utility and impact of different imaging modalities in detecting recurrent disease.
Main Methods:
- Review of published data on imaging techniques for rectal cancer recurrence.
- Analysis of sensitivity, specificity, and clinical impact of Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET).
Main Results:
- CT is widely used due to availability and speed, but MRI offers superior resolution for pelvic and liver recurrence.
- FDG-PET serves as a valuable third-level examination for unknown recurrence sites or pre-surgical assessment.
- Imaging sensitivity varies by modality and anatomical site.
Conclusions:
- Individualized follow-up strategies are essential for rectal cancer patients.
- Whole-body MRI is anticipated to become the preferred method for future recurrence screening due to its non-ionizing nature and comprehensive coverage.
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