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The Role of Radiologists in Multidisciplinary Tumor Boards for Colorectal Cancer with Liver Metastases: a Systematic
Kartik Gupta1, Abu Bakar Butt2, Ashley Farrell3
1Department of Radiology, University of Manitoba, Winnipeg, MB, Canada.
Background:
Colorectal cancer (CRC) is the third most common cancer globally, with 25-30% of patients eventually developing liver metastases (CRLM). These metastases worsen prognosis, emphasizing the need for multidisciplinary management. Within multidisciplinary teams (MDTs), radiologists do more than interpret images, facilitating accurate staging, resectability assessment, and therapy guidance. This systematic review assesses radiologists' impact and advanced imaging's role in CRLM.
Methods:
We searched Ovid MEDLINE, Ovid Epub, Cochrane Central, Embase, and Scopus (inception-August 31, 2023). Eligible studies involved adult CRC patients with CRLM, MDTs including radiologists, and reported on treatment decisions, survival, or imaging's influence.
Results:
From 13,043 references, 9 studies (8 retrospective, 1 prospective) met inclusion, with 2342 patients across six countries. PET/CT altered management in up to 10.6% of cases by detecting additional lesions or changing staging. In one study, virtual MDTs prevented unnecessary referrals in 43.9% of patients. Several studies suggested improved survival outcomes associated with MDT-based care. Radiologists contributed to staging, resectability evaluations, and decisions on liver-directed therapies. However incomplete data, variability in imaging protocols, and inconsistent reporting remained obstacles.
Conclusion:
Radiologists' expanding MDT role enhances CRLM management through improved disease characterization and treatment planning. However, definitive survival benefits remain uncertain due to retrospective designs, small sample sizes, and methodological heterogeneity. Prospective studies with standardized imaging protocols and consistent data integration are needed to better quantify radiologists' contributions. Virtual MDTs have promise in broadening access to specialist input, potentially improving outcomes and resource utilization in CRC with liver metastases.
