Are There Functional Imaging Markers to Consider for Treatment Decision Making?

  • Doenja M. J. Lambregts
  • Monique Maas
  • Regina G. H. Beets-Tan


We have entered a new era where imaging not only provides information on tumour size and morphology, but also on functional characteristics of the tumour thereby offering valuable insights into tumour biology, e.g. cellularity, metabolism and vascularity. So far, the largest body of evidence exists for positron emission tomography (PET), diffusion-weighted imaging (DWI) and perfusion imaging. DWI has so far mainly proven valuable for response evaluation after CRT, while PET seems to be particularly promising for early evaluation of response. Perfusion CT seems to be of value for assessment of unfavourable tumour characteristics, while dynamic contrast-enhanced MRI may predict and identify responders. Future large and prospective validation will need to determine the definite clinical value of these techniques.



Apparent diffusion coefficient


Area under the curve


Carcinoembryonic antigen




Computed tomography


Dynamic contrast enhanced


Disease free survival


Diffusion-weighted (magnetic resonance) imaging




Magnetic resonance imaging


Microvessel density


Nodal stage


Overall survival


Positron emission tomography/18F-fluorodeoxygenase positron emission tomography


Response Index


Standardized uptake value


Total mesorectal excision


Tumour Node Metastasis


Tumour stage


Time to peak


Volume of extracellular space


Vascular endothelial growth factor


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Copyright information

© Springer-Verlag Berlin Heidelberg 2018

Authors and Affiliations

  • Doenja M. J. Lambregts
    • 1
  • Monique Maas
    • 1
  • Regina G. H. Beets-Tan
    • 1
  1. 1.Department of RadiologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands

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