摘要
结直肠癌是常见的消化系统恶性肿瘤之一,约60%~70%的结直肠癌患者在确诊时已为局部进展期直肠癌(locally advanced rectal cancer,LARC),新辅助治疗(neoadjuvant treatment,NAT)是LARC患者的标准治疗方案,近年来,随着NAT在LARC中展现出良好的治疗效果,NAT在局部进展期结肠癌也得到了初步临床应用,但并非所有局部进展期结直肠癌(locally advanced colorectal cancer,LACRC)患者均能从NAT中获益。因此,术前精准评估NAT疗效,筛选NAT优势人群是一个亟待解决的临床问题。诸多证据表明影像学可在术前评估LACRC-NAT疗效。因此,本文就计算机体层成像(computed tomography,CT)、MRI、正电子发射计算机体层成像(positron emission tomography/computed tomography,PET/CT)、影像组学及深度学习在LACRC-NAT疗效评估中的应用现状、优势及局限性进行综述,旨在提升影像学评估LACRC-NAT疗效的准确性,为临床制订个体化的NAT方案提供全面、客观的影像学依据。
Colorectal cancer is one of the common malignancies of the digestive system,about 60%-70%of colorectal cancer patients have locally advanced rectal cancer(LARC)at the time of diagnosis,neoadjuvant therapy(NAT)is the standard treatment for patients with LARC,in recent years,with NAT showing good treatment response in LARC,NAT has also been initially used in locally advanced colorectal cancer,but not all patients with locally advanced colorectal cancer(LACRC)can benefit from NAT.Consequently,it is an urgent clinical problem to accurately evaluate the treatment response of NAT and screen the NAT dominant population before surgery.There is abundant evidence that imaging can be used to assess the response of LACRC-NAT preoperatively.Therefore,this article reviews the application status,advantages and limitations of computed tomography,MRI,positron emission tomography/computed tomography,radiomics and deep learning in the evaluation of the response of LACRC-NAT,aiming to improve the accuracy of imaging evaluation of the response of LACRC-NAT and provide a comprehensive and objective imaging basis for the clinical formulation of individualized NAT protocols.
作者
卢婷
王媛媛
周凤瑜
董文洁
杨海婷
周俊林
LU Ting;WANG Yuanyuan;ZHOU Fengyu;DONG Wenjie;YANG Haiting;ZHOU Junlin(Department of Radiology,Lanzhou University Second Hospital,Lanzhou 730030,China;Second Clinical School,Lanzhou University,Lanzhou 730000,China;Key Laboratory of Medical Imaging of Gansu Province,Lanzhou 730030,China;Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence,Lanzhou 730030,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2024年第5期209-215,221,共8页
Chinese Journal of Magnetic Resonance Imaging
基金
兰州大学第二医院“萃英科技创新”计划项目(编号:CY2021-ZD-01)。
关键词
结直肠癌
新辅助治疗
疗效评估
计算机体层成像
磁共振成像
人工智能
colorectal cancer
neoadjuvant treatment
treatment response assessment
computed tomography
magnetic resonance imaging
artificial intelligence
