PET/CT in Colorectal Cancer (Clinicians’ Guides to Radionuclide Hybrid Imaging)

"This book is a pocket guide to the science and practice of PET/CT imaging of colorectal malignancies. The role of PET/CT in these patients, the characteristic PET/CT findings, and the advantages and limitations of this hybrid modality are all clearly described. In addition, information is provided on clinical presentation, diagnosis, staging, pathology, management, and radiological imaging. The book is published within the Springer series Clinicians' Guides to Radionuclide Hybrid Imaging, which is aimed at nuclear medicine/radiology residents and physicians, referring clinicians, radiographers/technologists, and nurses who routinely work in nuclear medicine and participate in multidisciplinary meetings. Compiled under the auspices of the British Nuclear Medicine Society, the series is the joint work of many colleagues and professionals worldwide who share a common vision and purpose in promoting and supporting nuclear medicine as an important imaging specialty for the diagnosis and management of oncological and non-oncological conditions."--Prové de l'editor Foreword Preface Acknowledgements Contents Contributors 1: Introduction of Colorectal Cancer 1.1 Introduction 1.2 Epidemiology 1.3 Causes/Risk Factors 1.4 Clinical Presentation/Signs and Symptoms 1.5 Diagnosis 1.6 Faecal Occult Blood Testing (FOBT) 1.7 X-Ray with Barium Enema 1.8 Flexible Sigmoidoscopy 1.9 Colonoscopy 1.10 CT Colonography 1.11 Staging Procedures/Investigations 1.12 Staging of Colon Carcinoma References 2: Pathology of Colorectal Cancer 2.1 Histological Classification of Colorectal Cancers 2.2 TNM Classification 2.2.1 Duke Stages 2.2.2 Prognostic Factors References 3: Management of Colorectal Cancer 3.1 Role of the Multidisciplinary Team (MDT) 3.2 Management of Localised Disease 3.2.1 Surgery for Localised Disease 3.2.2 Rectal Tumours 3.3 Adjuvant Treatment in Localised Disease 3.3.1 Chemotherapy 3.4 Radiotherapy 3.4.1 Follow-Up 3.5 Treatment of Metastatic Colorectal Cancer (mCRC) 3.6 Systemic Therapy 3.6.1 Cytotoxics 3.6.1.1 Fluropyrimidine-Based Therapy 3.6.1.2 Doublet-Chemotherapy Regimens 3.7 Targeted Agents 3.7.1 Bevacizumab 3.8 Cetuximab 3.9 Aflibercept 3.10 Regorafenib 3.11 Role of Surgery in Advanced Colorectal Cancer 3.12 Other Modalities of Treatment References 4: Radiological Imaging of Colorectal Cancer 4.1 Staging of Colon Cancers Using CT 4.2 Assessment of Rectal Cancers 4.3 Summary of Rectal MRI Assessment Standards for Reporting 4.3.1 Baseline and Post-treatment Assessment of Rectal Cancer MRI 4.3.2 Minimum Standards for Reporting: References 5: 18F-FDG PET/CT: Normal Variants, Artefacts, and Pitfalls in Colorectal Cancer 5.1 Introduction 5.2 Physiological Variants 5.3 Artefacts and Imaging Pitfalls 5.4 Technical Artefacts 5.4.1 Misregistration 5.4.2 Partial Volume Effect 5.4.3 Attenuation Correction Artefacts 5.4.4 Truncation Artefacts 5.5 Organ- and Pathology-Specific Pitfalls 5.5.1 Liver 5.5.2 Spleen, Pancreas, and Adrenals 5.5.3 Stomach 5.5.4 Colon and Small Bowel 5.5.5 Urinary Tract 5.5.6 Reproductive System 5.5.7 Bone 5.5.8 Muscle 5.5.9 Lymph Nodes 5.5.10 Peritoneum 5.6 Treatment-Related Pitfalls References 6: PET/CT in Colorectal Cancer 6.1 Introduction 6.2 Primary Diagnosis/Staging 6.3 Response Assessment 6.4 Detection of Recurrent Disease 6.5 Normal Variants and Artefacts References 7: PET/CT in Colorectal Cancer-Pictorial Atlas 7.1 Case 1: Typical “Apple-Core” Appearance on CT of a Transverse Colon Primary. CT Staging: T3N2M0 7.2 Case 2: Sigmoid Colon Primary. CT Staging: T3N2M0 7.3 Case 3: Adenocarcinoma Within the Splenic Flexure of the Colon. On CT, the Approximately 5 cm Annular Lesion Is in Close Contact with the Anterior Surface and the Upper Pole of the Left Kidney as Illustrated Below. CT Staging: T4N2M0 7.4 Case 4: An Approximately 5 cm Annular Adenocarcinoma Within the Sigmoid Colon with Peri-­colonic Extramural Infiltration. CT Staging: T3N1M0 7.5 Case 5: Caecum Primary with Mesenteric Nodal and Extensive Liver Metastases. CT Staging: T3N1M1 7.6 Case 6: An Approximately 4 cm Annular Adenocarcinoma Within the Descending Colon with Peri-colonic Nodal Metastases and Adjacent Peritoneal Infiltration. CT Staging: T4N2M0 7.7 Case 7: An Approximately 5 cm Annular Adenocarcinoma Within the Transverse Colon in a Patient with a History of Chronic Lymphocytic Leukaemia (CLL). CT Staging: T3N1M0 7.8 Case 8: An Approximately 2 cm Semi-annular Adenocarcinoma Within the Rectum. MRI Staging: T2N0M0 7.9 Case 9: Moderately Differentiated Adenocarcinoma of the Low Rectum. MRI Staging: T4N2M0 7.10 Case 10: Locally Advanced Adenocarcinoma Within the Rectum Extending for Approximately 7 cm in Craniocaudal Length. MRI Staging: T4N2Mx 7.11 Case 11: Locally Advanced Rectal Adenocarcinoma with Multiple Mesorectal Nodal Metastases. FDG-PET/CT Staging: T4N2M0 7.12 Case 12: Moderately Differentiated Transverse Colon Cancer with a Solitary Segment VIII Liver Metastasis on Staging CT Scan and Subsequent Liver MRI Scan Was Indeterminate. FDG-PET/CT Staging: T3N1M0 7.13 Case 13: Recurrent Poorly Differentiated Adenocarcinoma of the Rectum 3 Years After Surgery 7.14 Case 14: Recurrent Colon Cancer 8 Years After Surgery 7.15 Case 15: Further Recurrence in the Right Hilum Following Resection of Solitary Lung Metastasis from a Dukes B Colon Cancer 7.16 Case 16: FDG-PET/CT Has Higher Sensitivity in Detecting Recurrent Colorectal Cancer 7.17 Case 17: Mucinous Colorectal Tumour Has Low FDG Avidity 7.18 Case 18: Postsurgical Inflammatory Changes Could Remain FDG Avid for a Protracted Time 7.19 Case 19: MRI in Assessing Response to Neoadjuvant Chemoradiotherapy in Lower Rectal Cancer 7.20 Case 20: FDG-PET/CT Is a very Useful Tool in Assessing Colorectal Cancer in Response to Chemo- or Radiotherapy Index "This book is a pocket guide to the science and practice of PET/CT imaging of colorectal malignancies. The role of PET/CT in these patients, the characteristic PET/CT findings, and the advantages and limitations of this hybrid modality are all clearly described. In addition, information is provided on clinical presentation, diagnosis, staging, pathology, management, and radiological imaging. The book is published within the Springer series Clinicians' Guides to Radionuclide Hybrid Imaging, which is aimed at nuclear medicine/radiology residents and physicians, referring clinicians, radiographers/technologists, and nurses who routinely work in nuclear medicine and participate in multidisciplinary meetings. Compiled under the auspices of the British Nuclear Medicine Society, the series is the joint work of many colleagues and professionals worldwide who share a common vision and purpose in promoting and supporting nuclear medicine as an important imaging specialty for the diagnosis and management of oncological and non-oncological conditions."--Prové de l'editor