Review
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World J Gastroenterol. Dec 14, 2014; 20(46): 17345-17351
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17345
Computed tomography perfusion imaging as a potential imaging biomarker of colorectal cancer
Koichi Hayano, Takeshi Fujishiro, Dushyant V Sahani, Asami Satoh, Tomoyoshi Aoyagi, Gaku Ohira, Toru Tochigi, Hisahiro Matsubara, Kiyohiko Shuto
Koichi Hayano, Dushyant V Sahani, Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, United States
Takeshi Fujishiro, Asami Satoh, Tomoyoshi Aoyagi, Gaku Ohira, Toru Tochigi, Hisahiro Matsubara, Department of Frontier surgery, Chiba university Graduate School of Medicine, Chiba 260-8677, Japan
Kiyohiko Shuto, Department of Surgery, Teikyo University Medical Center, Ichihara, Chiba 299-0111, Japan
Author contributions: Hayano K, Fujishiro T and Shuto K contributed to conception and design; all authors contributed to manuscript writing and preparing figures; and all authors reviewed and approved this article to be published.
Correspondence to: Koichi Hayano, MD, PhD, Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114, United States. khayano@partners.org
Telephone: +1-617-7268361 Fax: +1-617-7264891
Received: February 28, 2014
Revised: April 1, 2014
Accepted: July 22, 2014
Published online: December 14, 2014
Abstract

Neovascularization was reported to arise early in the adenoma-carcinoma sequence in colorectal cancer (CRC), and the importance of angiogenesis in cancer progression has been established. Computed tomography (CT) perfusion (CTP) based on high temporal resolution CT images enables evaluation of hemodynamics of tissue in vivo by modeling tracer kinetics. CTP has been reported to characterize tumor angiogenesis, and to be a sensitive marker for predicting recurrence or survival in CRC. In this review, we will discuss the biomarker value of CTP in the management of CRC patients.

Keywords: Colorectal cancer, Angiogenesis, Computed tomography perfusion, Antiangiogenic therapy, Chemoradiation therapy

Core tip: The importance of angiogenesis, which is an essential process of colorectal cancer (CRC), has been established. Therefore, the in vivo measure of angiogenesis such as computed tomography (CT) perfusion (CTP) technique can be a robust imaging biomarker in CRC. Especially, CTP certainly fulfils the criteria necessary for prospective validation as a clinical trial end point, because CT is a stable platform, broadly available, and non-invasive. Therefore, we believe that CTP will plays an important role in the management of CRC, providing patients more personalized and effective treatment.