The Role of Functional Imaging in Colorectal Cancer

Department of Radiology, Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain. <>
American Journal of Roentgenology (Impact Factor: 2.73). 07/2010; 195(1):54-66. DOI: 10.2214/AJR.10.4422
Source: PubMed


OBJECTIVE: This article reviews the current and future contributions of functional imaging techniques to improve diagnosis, prognosis, and treatment of colorectal cancer. In addition, evolving roles and challenges for their implementation will be covered. CONCLUSION: Functional imaging now has a growing role in colorectal cancer. Recent developments in imaging technologies and validation of these newer imaging techniques may lead to significant improvements in the management of patients with colorectal cancer.

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    • "The linear relationship between tissue attenuation and iodine concentration has simplified various analysis models and facilitated the understanding of underlying physiological principles. With perfusion imaging representing a well-established evaluation technique in stroke patients [2], CT perfusion has been applied to many areas of the body including the lung, abdominal and pelvic organs, predominantly with oncological indications [3–5]. Lesion characterisation, identification of occult malignancies, provision of prognostic information based on tumour vascularity and monitoring the therapeutic effects predominantly of anti-angiogenic drugs have been the key targets for abdominal perfusion CT [6–9]. "
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    ABSTRACT: To compare two scanning protocols (free breathing versus breath-hold) for perfusion imaging using dynamic volume computed tomography (CT) and to evaluate their effects on image registration. Forty patients underwent dynamic volume CT for pancreatic perfusion analysis and were randomly assigned to either a shallow-breathing (I) or breath-hold (II) group. Both dynamic CT protocols consisted of 17 low-dose volumetric scans. Rigid image registration was performed by using the volume with highest aortic attenuation as reference. All other volumes were visually matched with the pancreatic lesion serving as the volumetric region of interest. The overall demand for post-processing per patient was calculated as the median of three-dimensional vector lengths of all volumes in relation to the relative patient origin. The number of volumes not requiring registration was recorded per group. Registration mismatch for groups I and II was 2.61 mm (SD, 1.57) and 4.95 mm (SD, 2.71), respectively (P < 0.005). Twenty-eight volumes in group I (8.2%) and 47 volumes in group II (14.1%) did not require manual registration (P = 0.014). Shallow breathing during dynamic volume CT scanning reduces the overall demand for motion correction and thus may be beneficial in perfusion imaging of the pancreas MAIN MESSAGES: • Shallow breathing during perfusion CT scanning reduces the overall demand for motion correction. • Shallow breathing may be beneficial in perfusion imaging of the pancreas. • Image registration is crucial for CT perfusion imaging.
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