Lo Hui Zhen, Choy Kay Tai, Kong Joseph Cherng Huei
School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
Department of Surgery, Austin Health, Melbourne, VIC, Australia.
Abdom Radiol (NY). 2025 Jan;50(1):49-63. doi: 10.1007/s00261-024-04460-z. Epub 2024 Jul 29.
Since its introduction in 2011, FDG-PET/MRI has been advocated as a useful adjunct in colorectal cancer care. However, gaps and limitations in current research remain. This systematic review aims to review the current literature to quantify the utility of FDG-PET/MRI in colorectal cancer care.
An up-to-date review was performed on the available literature between 2000 and 2023 on PubMed, EMBASE, Medline, databases. All studies reporting on the use of FDG-PET/MRI in colorectal cancer care were analyzed. The main outcome measures were accuracy in initial staging, restaging, and detection of metastatic disease in both rectal as well as colon cancers. The secondary outcome was comparing the performance of FDG-PET/MRI versus Standard of Care Imaging (SCI). Finally, the clinical significance of FDG-PET/MRI was measured in the change in management resulting from imaging findings.
A total of 22 observational studies were included, accounting for 988 patients. When individually compared to current Standard of Care Imaging (SCI)-MRI pelvis for rectal cancer and thoraco-abdominal contrast CT, PET/MRI proved superior in terms of distant metastatic disease detection. This led to as much as 21.0% change in management. However, the technological limitations of PET/MRI were once again highlighted, suggesting SCI should retain its place as first-line imaging.
FDG-PET/MRI appears to be a promising adjunct in staging and restaging of colorectal cancer in carefully selected patients.
自2011年引入以来，氟代脱氧葡萄糖正电子发射断层显像/磁共振成像（FDG-PET/MRI）一直被视为结直肠癌治疗中的一种有用辅助手段。然而，当前研究仍存在差距和局限性。本系统评价旨在回顾当前文献，以量化FDG-PET/MRI在结直肠癌治疗中的效用。
对2000年至2023年期间在PubMed、EMBASE、Medline数据库上的现有文献进行了最新综述。分析了所有报道FDG-PET/MRI在结直肠癌治疗中应用的研究。主要结局指标是直肠癌和结肠癌初始分期、再分期以及转移病灶检测的准确性。次要结局是比较FDG-PET/MRI与标准护理成像（SCI）的性能。最后，通过影像学检查结果导致的治疗变化来衡量FDG-PET/MRI的临床意义。
共纳入22项观察性研究，涉及988例患者。与目前用于直肠癌的标准护理成像（SCI）-盆腔MRI和胸腹对比CT单独比较时，PET/MRI在远处转移病灶检测方面表现更优。这导致治疗变化高达21.0%。然而，PET/MRI的技术局限性再次凸显，表明SCI应保留其作为一线成像的地位。
对于精心挑选的患者，FDG-PET/MRI似乎是结直肠癌分期和再分期中一种有前景的辅助手段。
