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Are There Functional Imaging Markers to Consider for Treatment Decision Making?

  • Doenja M. J. Lambregts
  • Monique Maas
  • Regina G. H. Beets-Tan
Chapter

Abstract

We have entered a new era where imaging not only provides information on tumour size and morphology, but also on functional characteristics of the tumour thereby offering valuable insights into tumour biology, e.g. cellularity, metabolism and vascularity. So far, the largest body of evidence exists for positron emission tomography (PET), diffusion-weighted imaging (DWI) and perfusion imaging. DWI has so far mainly proven valuable for response evaluation after CRT, while PET seems to be particularly promising for early evaluation of response. Perfusion CT seems to be of value for assessment of unfavourable tumour characteristics, while dynamic contrast-enhanced MRI may predict and identify responders. Future large and prospective validation will need to determine the definite clinical value of these techniques.

Abbreviations

ADC

Apparent diffusion coefficient

AUC

Area under the curve

CEA

Carcinoembryonic antigen

CRT

Chemoradiotherapy

CT

Computed tomography

DCE

Dynamic contrast enhanced

DFS

Disease free survival

DWI

Diffusion-weighted (magnetic resonance) imaging

FMISO

Fluoromisonidazole

MRI

Magnetic resonance imaging

MVD

Microvessel density

N-stage

Nodal stage

OS

Overall survival

PET/FDG-PET

Positron emission tomography/18F-fluorodeoxygenase positron emission tomography

RI

Response Index

SUV

Standardized uptake value

TME

Total mesorectal excision

TNM

Tumour Node Metastasis

T-stage

Tumour stage

TTP

Time to peak

Ve

Volume of extracellular space

VEGF

Vascular endothelial growth factor

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Copyright information

© Springer-Verlag Berlin Heidelberg 2018

Authors and Affiliations

  • Doenja M. J. Lambregts
    • 1
  • Monique Maas
    • 1
  • Regina G. H. Beets-Tan
    • 1
  1. 1.Department of RadiologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands

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