Morawska I, Cieszanowski A. Assessment of the response to systemic treatment of colorectal liver metastases on cross-sectional imaging - a systematic review.
Pol J Radiol 2023;
88:e512. [PMID:
38125815 PMCID:
PMC10731444 DOI:
10.5114/pjr.2023.132884]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/03/2023] [Indexed: 12/23/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common malignancies in the world. Nowadays many treatments are available to help control CRC, including surgery, radiation therapy, interventional radiology, and drug treatments. A multidisciplinary approach and the role of radiologists is needed to assist the surgeon in the management thanks to emerging technology and strategies. The Response Evaluation Criteria in Solid Tumours (RECIST) has been created to objectify and standardize cancer response assessment. Thus, in this article specific presumptions and practical aspects of evaluating responses according to the RECIST 1.1 are discussed. Furthermore, examples of possible response to systemic treatment of colorectal liver metastases (CRLM), including tumour necrosis, apparent diffusion coefficient (ADC) values, tumour calcification, tumour fibrosis and intratumoural fat deposition observed on cross-sectional imaging, are described. Disappearing liver metastases (DLM) presents a therapeutic dilemma. The optimal management of DLM remains controversial due to the uncertainty of residual microscopic disease and effective long-term outcomes. The article provides an overview of the CRLM phenomenon and current possible assessment methods of the response to systemic treatment.
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