Abstract
Positron emission tomography/magnetic resonance imaging (PET/MRI), a hybrid imaging method, is increasingly used in colorectal cancers. In PET/MRI, the advantages of MRI, which is an anatomical method, and F-18 fluorodeoxyglucose PET imaging, which is a functional method, are used simultaneously. Rectal cancer PET/MR protocols generally include axial, coronal, and sagittal images taken from the pelvic region using T1- and T2-weighted imaging. For staging of the primary tumor, PET/MRI may help better define the size of the tumor as well as the extent of the tumor beyond the muscularis propria. PET imaging can help characterize small lymph nodes seen on MRI and may improve the detection of hepatic metastases not yet seen on computerized tomography with imaging from the liver. Another useful aspect of PET/MRI is evaluation of response to treatment. Limitations of PET/MRI include the inability to detect small lung nodules and problems with attenuation correction. As a result, PET/MRI can improve the staging of colorectal cancers and contribute to treatment management.
Keywords: Colorectal cancers, PET/MRI, FDG
References
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69-90.
Rao SX, Zeng MS, Xu JM, et al. Assessment of T staging and mesorectal fascia status using high-resolution MRI in rectal cancer with rectal distention. World J Gastroenterol. 2007;13:4141-4146.
NCCN Clinical Practice Guidelines in Oncology: Colon Cancer. National Comprehensive Cancer Network. Available at http://www.nccn.org/professionals/physician_gls/pdf/colon.pdf. Version 1.2024 — January 29, 2024; Accessed: February 13, 2024.
Cerny M, Dunet V, Prior JO, et al. Initial staging of locally advanced rectal cancer and regional lymph nodes: comparison of diffusion-weighted MRI with 18F-FDG-PET/CT. Clin Nucl Med. 2016;41:289-295.
Boellaard R, Quick HH. Current image acquisition options in PET/MR. Semin Nucl Med. 2015;45:192-200.
Schwenzer NF, Schmidt H, Claussen CD. Whole-body MR/PET: applications in abdominal imaging. Abdom Imaging. 2012;37:20-28.
Horvat N, Carlos Tavares Rocha C, Clemente Oliveira B, Petkovska I, Gollub MJ. MRI of rectal cancer: tumor staging, ımaging techniques, and management. Radiographics. 2019;39:367-387.
Jeong JH, Cho IH, Chun KA, Kong EJ, Kwon SD, Kim JH. Correlation between apparent diffusion coefficients and standardized uptake values in hybrid (18)F-FDG PET/MR: preliminary results in rectal cancer. Nucl Med Mol Imaging. 2016;50:150-156.
Buchbender C, Heusner TA, Lauenstein TC, Bockisch A, Antoch G. Oncologic PET/MRI, part 1: tumors of the brain, head and neck, chest, abdomen, and pelvis. J Nucl Med. 2012;53:928-938.
Rosenkrantz AB, Friedman K, Chandarana H, et al. Current status of hybrid pet/MRI in oncologic imaging. AJR Am J Roentgenol. 2016;206:162-172.
Langman G, Patel A, Bowley DM. Size and distribution of lymph nodes in rectal cancer resection specimens. Dis Colon Rectum. 2015;58:406-414.
Mirshahvalad SA, Hinzpeter R, Kohan A, et al. Diagnostic performance of [18F]-FDG PET/MR in evaluating colorectal cancer: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging. 2022;49:4205-4217.
Catalano OA, Coutinho AM, Sahani DV, et al. Colorectal cancer staging: comparison of whole-body PET/CT and PET/MR. Abdom Radiol (NY). 2017;42:1141-1151.
Lambrecht M, Deroose C, Roels S, et al. The use of FDG-PET/CT and diffusion-weighted magnetic resonance imaging for response prediction before, during and after preoperative chemoradiotherapy for rectal cancer. Acta Oncol. 2010;49:956-963.
Brendle C, Schwenzer NF, Rempp H, et al. Assessment of metastatic colorectal cancer with hybrid imaging: comparison of reading performance using different combinations of anatomical and functional imaging techniques in PET/MRI and PET/CT in a short case series. Eur J Nucl Med Mol Imaging. 2016;43:123-132.
Mainenti PP, Stanzione A, Guarino S, et al. Colorectal cancer: parametric evaluation of morphological, functional and molecular tomographic imaging. World J Gastroenterol. 2019;25:5233-5256.
Stolzmann P, Veit-Haibach P, Chuck N, et al. Detection rate, location, and size of pulmonary nodules in trimodality PET/CT-MR: comparison of low-dose CT and Dixon-based MR imaging. Invest Radiol. 2013;48:241-246.
Hope TA, Kassam Z, Loening A, McNamara MM, Paspulati R. The use of PET/MRI for imaging rectal cancer. Abdom Radiol (NY). 2019;44:3559-3568.
Plodeck V, Platzek I, Streitzig J, et al. Diagnostic performance of 18F-fluorodeoxyglucose-PET/MRI versus MRI alone in the diagnosis of pelvic recurrence of rectal cancer. Abdominal Radiology. 2021;46:5086-5094.
Paspulati RM, Partovi S, Herrmann KA, Krishnamurthi S, Delaney CP, Nguyen NC. Comparison of hybrid FDG PET/MRI compared with PET/CT in colorectal cancer staging and restaging: a pilot study. Abdom Imaging. 2015;40:1415-1425.
Giannini V, Mazzetti S, Bertotto I, et al. Predicting locally advanced rectal cancer response to neoadjuvant therapy with 18F-FDG PET and MRI radiomics features. Eur J Nucl Med Mol Imaging. 2019;46:878-888.


