F-18 FDG uptake in hemorrhoids in a patient with diffuse large B-cell lymphoma

Molecular Imaging and Therapy of Colorectal and Anal Cancer

Colorectal cancer is the cancer with the third highest incidence both in males and females in the USA and is also frequently occurring in other industrialized nations. Anal cancer on the other hand is much rarer, but has a rising incidence, especially in high income nations and with a connection to HIV infections, homosexual men and a younger age of the first sexual encounter. Both have high mortality rates in common and are complex to handle in terms of prevention, staging, treatment and diagnostic of recurrence. This article aims to give an overview about the established diagnostic methods of nuclear medicine, especially sole PET and (contrast enhanced) hybrid imaging with 18F-FDG as tracer for primary staging, restaging, therapy monitoring and radiotherapy planning in current guidelines, with a special focus on the American guidelines of the National Comprehensive Cancer Network for colorectal and anal cancer. There will also be an outlook on potential future adjustments in those leading to a more significant representation of nuclear medicine by giving a synopsis of the available studies and data published in international medical press. New tracers that are still in research stage, progress in the imaging techniques, for example a further establishment of PET/MR hybrid imaging, the use of artificial intelligence and parametric imaging, as well as possible future theranostic applications like c-MET binding peptides will also be shortly discussed.