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Monitoring and Predicting Response to Therapy with ¹⁸F-FDG PET in Colorectal Cancer: A Systematic Review

¹ Department of Nuclear Medicine, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands; and ² Department of Medical Oncology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands

Correspondence: For correspondence or reprints contact: Lioe-Fee de Geus-Oei, Department of Nuclear Medicine, Internal Postal Code 444, Radboud University, Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: L.deGeus-Oei{at}nucmed.umcn.nl

Molecular imaging with ¹⁸F-FDG PET has been proven useful in the management of colorectal cancer. ¹⁸F-FDG PET plays a pivotal role in staging before surgical resection of recurrent colorectal cancer and metastases, in the localization of recurrence in patients with an unexplained rise in serum carcinoembryonic antigen levels, and in the assessment of residual masses after treatment. Currently, there is increasing interest in the role of ¹⁸F-FDG PET beyond staging. The technique appears to have significant potential for the characterization of tumors and for the prediction of prognosis in the context of treatment stratification and early assessment of tumor response to therapy. This systematic review provides an overview of the literature on the value of ¹⁸F-FDG PET for monitoring and predicting the response to therapy in colorectal cancer. The review covers chemotherapy response monitoring in advanced colorectal cancer, monitoring of the effects of local ablative therapies, and preoperative radiotherapy and multimodality treatment response evaluation in primary rectal cancer. Given the added value of ¹⁸F-FDG PET for these indications, implementation in clinical practice and systematic inclusion in therapeutic trials to exploit the potential of ¹⁸F-FDG PET are warranted.

Key Words: ¹⁸F-FDG PET • colorectal carcinoma • prediction • response monitoring • therapy monitoring

COPYRIGHT © 2009 by the Society of Nuclear Medicine, Inc.

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