Hunter Chris, Brown Gina
a Department of Colorectal Surgery , Hull and East Yorkshire NHS Trust , Hull , UK.
b Department of Surgery and Cancer , Imperial College London , London , UK.
Expert Rev Gastroenterol Hepatol. 2016 Sep;10(9):1011-25. doi: 10.1080/17474124.2016.1179577. Epub 2016 May 12.
The treatment of rectal cancer has diversified in recent years, presenting the clinician and patient with increasingly challenging management decisions. At the heart of this decision-making process are two competing interests; more radical but more morbid treatments which optimize oncological outcome, and less radical treatments which preserve organs and function but may pose a greater risk of disease recurrence.
Imaging plays a vital role informing this decision-making process, both by providing prognostic details about the cancer before the start of treatment and by updating this picture as the cancer responds or fails to respond to treatment. There is a range of available imaging modalities, each with its strengths and weaknesses. Optimizing rectal cancer treatment requires a clear understanding of the important questions that imaging needs to answer and the optimum imaging strategy. Expert Commentary: This article provides an evidence-based review of the available imaging techniques and an expert commentary on the best imaging strategy.
近年来,直肠癌的治疗方法日益多样化,这给临床医生和患者带来了越来越具有挑战性的管理决策。在这个决策过程的核心是两种相互竞争的利益;更激进但更具病态性的治疗方法可优化肿瘤学结果,而不太激进的治疗方法可保留器官和功能,但可能带来更大的疾病复发风险。
影像学在这一决策过程中起着至关重要的作用,既通过在治疗开始前提供有关癌症的预后细节,又通过随着癌症对治疗的反应或无反应而更新这一情况。有一系列可用的成像方式,每种都有其优缺点。优化直肠癌治疗需要清楚了解影像学需要回答的重要问题以及最佳成像策略。
本文对可用的成像技术进行了基于证据的综述,并对最佳成像策略进行了专家评论。