We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us

Download Mobile App

Early Chest Imaging Can Benefit Colorectal Cancer Patients

By MedImaging International staff writers
Posted on 18 Oct 2022
Print article
Image: Timely surveillance with chest imaging may benefit colorectal cancer patients (Photo courtesy of MD Anderson)
Image: Timely surveillance with chest imaging may benefit colorectal cancer patients (Photo courtesy of MD Anderson)

Despite improved survival rates, colorectal cancer is the third leading cause of cancer-related deaths in the U.S. Though rates of colorectal cancer have declined among people 65 and older, largely thanks to increased screening efforts, rates among younger adults are rising. When the cancer is caught early, many patients can remain disease-free for the rest of their lives after surgical treatment, but colorectal cancer can spread (metastasize) in up to 50% of patients. One of the most common areas colorectal cancer spreads to is the lungs, affecting up to 18% of patients with colorectal cancer. Detecting cancerous nodules in the lung early provides patients with the best outcomes, but there are no evidence-based standards for when and how often to screen colorectal cancer patients with chest CT or PET scans. Now, a new study has found that colorectal cancer patients with certain clinical characteristics may benefit from more frequent chest imaging to help identify and target cancer that has spread to the lungs. These findings have the potential to improve long-term outcomes of patients with metastatic colorectal cancer.

The study by researchers at the MD Anderson Cancer Center (Houston, TX, USA) investigated optimal timing intervals and key clinical factors, including genetic factors and tumor characteristics, that may reveal which patients are at risk for developing lung metastases. To identify which colorectal cancer patients may benefit from early chest imaging and at what time intervals, an interdisciplinary team of researchers – including cardiothoracic surgeons, colorectal cancer surgeons, and gastrointestinal oncologists – collaborated to investigate evidence-based surveillance guidelines for colorectal patients who are at risk of developing lung metastases.

Using two MD Anderson cancer databases that included both colorectal cancer patients and thoracic cancer patients, the study team retrospectively reviewed data from patients with colorectal cancer who did and did not develop lung metastases. Patients were grouped according to the development of lung metastases and the timing of their diagnosis. The team used statistical methods to investigate which clinical characteristics, such as age or genetic factors, correlated most with the risk of developing lung metastases. The findings of the study revealed that out of 1,600 patients with colorectal cancer, 233 (14.6%) developed pulmonary (lung) metastases, with a median time of 15.4 months following colorectal surgery. The team identified age, neoadjuvant or adjuvant systemic therapy (such as chemotherapy or immunotherapy), lymph node ratio, lymphovascular and perineural invasion (high-risk tumor characteristics observed under a microscope), and presence of KRAS genetic mutations as risk factors for developing lung metastases.

Further data analysis revealed that patients who required systemic therapy around the time of their surgical operation for colorectal cancer, who had an elevated lymph node ratio, and a KRAS mutation, were at risk of developing lung metastases within three months of surgery. The authors concluded that these patients may benefit from more frequent surveillance with chest CT or PET scans. The researchers noted that while these risk factors are not necessarily surprising from a clinical perspective, they highlight the need to adequately screen certain colorectal cancer patients after surgical treatment. In some cases, removing cancerous lung nodules surgically early on can significantly improve outcomes. In future research, the team plans to validate findings in a separate group of patients, with the hope of formalizing chest surveillance protocols for widespread clinical adoption. The researchers have noted that as colorectal cancer research evolves, sensitive blood tests to detect cancer or advanced radiographic screening methods using artificial intelligence may also play an important role in monitoring patients.

“After patients are diagnosed with colorectal cancer, many of them want to better understand what their cancer diagnosis entails in terms of their surveillance and survivorship for the rest of their life, but we currently lack data and uniform guidelines to support how often these patients should be screened with chest imaging,” said co-author Mara Antonoff, MD, FACS, associate professor, thoracic and cardiovascular surgery, UT MD Anderson Cancer Center. “With this study, we sought to develop a strategy that is evidence-based to determine how frequently, at what intervals, and for how long patients at risk of developing lung metastases should undergo imaging of their chest.”

“A concrete clinical application of this research, following validation, is to build evidence-based guidelines affecting chest surveillance in patients with resected colorectal cancer,” said Nathaniel Deboever, MD, general surgery resident, UTHealth Houston McGovern Medical School, and the lead author of the study. “These guidelines will hopefully allow high-risk patients to undergo radiographic screening in a timely manner, permitting the early diagnosis of pulmonary disease.”

Related Links:
MD Anderson Cancer Center

Print article



view channel
Image: Physicians using the Zenition 90 Motorized mobile X-ray system (Photo courtesy of Royal Philips)

High-Powered Motorized Mobile C-Arm Delivers State-Of-The-Art Images for Challenging Procedures

During complex surgical procedures, clinicians depend on surgical imaging systems as they navigate challenging anatomy to quickly visualize small anatomical details while minimizing X-ray exposure.... Read more


view channel
Image: The device creates microbubbles that temporarily disrupt the BBB, permitting the entry of immunotherapy into the brain (Photo courtesy of Northwestern)

Ultrasound Technology Breaks Blood-Brain Barrier for Glioblastoma Treatment

Despite extensive molecular studies, the outlook for patients diagnosed with the aggressive brain cancer known as glioblastoma (GBM) continues to be poor. This is partly due to the blood-brain barrier... Read more

Nuclear Medicine

view channel
Image: 68Ga-NC-BCH whole-body PET imaging rapidly targets an important gastrointestinal cancer biomarker in lesions in GI cancer patients (Photo courtesy of Qi, Guo, et al.; doi.org/10.2967/jnumed.123.267110)

New PET Radiotracer Enables Same-Day Imaging of Key Gastrointestinal Cancer Biomarker

Gastrointestinal cancers rank among the most prevalent cancers worldwide, contributing to over a quarter of all cancer cases and over one-third of cancer-related deaths annually. The initial symptoms of... Read more

Imaging IT

view channel
Image: The new Medical Imaging Suite makes healthcare imaging data more accessible, interoperable and useful (Photo courtesy of Google Cloud)

New Google Cloud Medical Imaging Suite Makes Imaging Healthcare Data More Accessible

Medical imaging is a critical tool used to diagnose patients, and there are billions of medical images scanned globally each year. Imaging data accounts for about 90% of all healthcare data1 and, until... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.