ctDNA in the reading room: A guide for radiologists

Area of Science:

• Oncology
• Radiology
• Molecular Diagnostics

Background:

• Liquid biopsy with circulating tumor DNA (ctDNA) sequencing is a less invasive alternative to tissue biopsies.
• ctDNA analysis identifies cancer-specific molecular signatures, treatment response, resistance, progression, and recurrence.
• Radiologists face evolving challenges in interpreting oncologic imaging due to ctDNA advancements.

Purpose of the Study:

• To provide an overview of ctDNA testing and its clinical applications.
• To review current National Comprehensive Cancer Network and European Society of Molecular Oncology guidelines for ctDNA use.
• To highlight ctDNA research applications relevant to diagnostic radiology across various cancers.

Main Methods:

• Review of current literature and clinical guidelines on ctDNA testing.
• Analysis of ctDNA applications in lung, breast, colorectal, pancreatic, and hepatobiliary cancers.
• Examination of imaging correlates and research applications of ctDNA.

Main Results:

• ctDNA aids in identifying actionable targets and monitoring treatment efficacy.
• ctDNA is crucial for detecting minimal residual disease and cancer recurrence.
• Clinical guidelines increasingly incorporate ctDNA in cancer management.

Conclusions:

• Radiologists must understand ctDNA's role in cancer surveillance and treatment monitoring.
• Familiarity with ctDNA applications is essential for interpreting oncologic imaging.
• ctDNA integration impacts diagnostic radiology and personalized cancer care.