Review
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 14, 2009; 15(26): 3228-3231
Published online Jul 14, 2009. doi: 10.3748/wjg.15.3228
Perfusion computed tomography in colorectal cancer: Protocols, clinical applications and emerging trends
Guang-Yao Wu, Prasanna Ghimire
Guang-Yao Wu, Prasanna Ghimire, Department of Magnetic Resonance Imaging, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China
Author contributions: Wu GY and Ghimire P contributed equally to this paper.
Correspondence to: Guang-Yao Wu, MD, PhD, Department of Magnetic Resonance Imaging, Zhongnan Hospital, Wuhan University, 169 East Lake Road, Wuhan 430071, Hubei Province, China. wuguangy2002@yahoo.com.cn
Telephone: +86-27-67813187
Fax: +86-27-67813188
Received: May 4, 2009
Revised: May 19, 2009
Accepted: May 26, 2009
Published online: July 14, 2009
Abstract

Perfusion computed tomography (CT) has emerged as a novel functional imaging technique with gradually increasing importance in the management of colorectal cancer (CRC). By providing the functional tumor microvasculature, it also helps the assessment of therapeutic response of anti-angiogenic drugs as it may reflect tumor angiogenesis. Perfusion CT has been applied in clinical practice to delineate inflammatory or neoplastic lymph nodes irrespective of their size, identify micro-metastases and to predict metastases in advance of their development. It is of increasing significance for preoperative adjuvant therapies and avoidance of unnecessary interventions. Despite controversies regarding the techniques employed, its validity and reproducibility, it can be advantageous in the management of CRCs in which the prognosis is dependent on preoperative staging. With recent advances in the perfusion CT techniques, and incorporation to other modalities like positron emission tomography, perfusion CT will be a novel tool in the overall management of CRCs. This article aims at reviewing the existing clinical applications and recent advances of perfusion CT with a reference to future development in the management of CRCs.

Keywords: Colorectal cancers; Perfusion computed tomography; Angiogenesis; Neovascularization; Micrometastases