Modern MR Imaging Technology in Rectal Cancer; There Is More Than Meets the Eye

Haak, Hester E.; Maas, Monique

doi:10.3389/fonc.2020.537532

Cited by 10 publications

(3 citation statements)

References 63 publications

(96 reference statements)

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“…Moreover, hyperglycemia can cause accumulation of advanced glycation end products (AGEs) [ 36 ], leading to stimulation of chronic inflammation, oxidative stress, and tumorigenesis. The expression of AGEs receptor (RAGE), which is found to be associated with survival of colon cancer cells [ 37 ], is upregulated owing to the higher concentration of AGEs [ 38 ]. Thus, enhanced AGEs-RAGE interaction may be the missing link between diabetes and increased risk of CRC [ 39 ].…”

Section: Pathophysiological Links Between T2dm and Crcmentioning

confidence: 99%

Diabetes and Colorectal Cancer Risk: Clinical and Therapeutic Implications

Wei

et al. 2022

Journal of Diabetes Research

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Several epidemiological studies have identified diabetes as a risk factor for colorectal cancer (CRC). The potential pathophysiological mechanisms of this association include hyperinsulinemia, insulin-like growth factor (IGF) axis, hyperglycemia, inflammation induced by adipose tissue dysfunction, gastrointestinal motility disorder, and impaired immunological surveillance. Several studies have shown that underlying diabetes adversely affects the prognosis of patients with CRC. This review explores the novel anticancer agents targeting IGF-1R and receptor for advanced glycation end products (RAGE), both of which play a vital role in diabetes-induced colorectal tumorigenesis. Inhibitors of IGF-1R and RAGE are expected to become promising therapeutic choices, particularly for CRC patients with diabetes. Furthermore, hypoglycemic therapy is associated with the incidence of CRC. Selection of appropriate hypoglycemic agents, which can reduce the risk of CRC in diabetic patients, is an unmet issue. Therefore, this review mainly summarizes the current studies concerning the connections among diabetes, hypoglycemic therapy, and CRC as well as provides a synthesis of the underlying pathophysiological mechanisms. Our synthesis provides a theoretical basis for rational use of hypoglycemic therapies and early diagnosis and treatment of diabetes-related CRC.

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Section: Pathophysiological Links Between T2dm and Crcmentioning

confidence: 99%

Diabetes and Colorectal Cancer Risk: Clinical and Therapeutic Implications

Wei

et al. 2022

Journal of Diabetes Research

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“…Based on this clinical response assessment patients undergo further treatment or are enrolled in W&W. After surgery the resected tissue is analyzed by a pathologist, resulting in a pathological response assessment, which remains the gold standard. In approximately 15% of patients that are considered clinical incomplete responders, no residual tumor tissue is present upon histopathological evaluation of the resected specimen ( 11 ). These patients undergo major surgery where organ-sparing treatment could have been possible.…”

Section: Introductionmentioning

confidence: 99%

Size and depth of residual tumor after neoadjuvant chemoradiotherapy in rectal cancer – implications for the development of new imaging modalities for response assessment

van der Stel,

van den Berg,

Snaebjornsson

et al. 2023

Front. Oncol.

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With the shift towards organ preserving treatment strategies in rectal cancer it has become increasingly important to accurately discriminate between a complete and good clinical response after neoadjuvant chemoradiotherapy (CRT). Standard of care imaging techniques such as CT and MRI are well equipped for initial staging of rectal tumors, but discrimination between a good clinical and complete response remains difficult due to their limited ability to detect small residual vital tumor fragments. To identify new promising imaging techniques that could fill this gap, it is crucial to know the size and invasion depth of residual vital tumor tissue since this determines the requirements with regard to the resolution and imaging depth of potential new optical imaging techniques. We analyzed 198 pathology slides from 30 rectal cancer patients with a Mandard tumor regression grade 2 or 3 after CRT that underwent surgery. For each patient we determined response pattern, size of the largest vital tumor fragment or bulk and the shortest distance from the vital tumor to the luminal surface. The response pattern was shrinkage in 14 patients and fragmentation in 16 patients. For both groups combined, the largest vital tumor fragment per patient was smaller than 1mm for 38% of patients, below 0.2mm for 12% of patients and for one patient as small as 0.06mm. For 29% of patients the vital tumor remnant was present within the first 0.01mm from the luminal surface and for 87% within 0.5mm. Our results explain why it is difficult to differentiate between a good clinical and complete response in rectal cancer patients using endoscopy and MRI, since in many patients submillimeter tumor fragments remain below the luminal surface. To detect residual vital tumor tissue in all patients included in this study a technique with a spatial resolution of 0.06mm and an imaging depth of 8.9mm would have been required. Optical imaging techniques offer the possibility of detecting majority of these cases due to the potential of both high-resolution imaging and enhanced contrast between tissue types. These techniques could thus serve as a complimentary tool to conventional methods for rectal cancer response assessment.

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“…Radiotherapy planning for rectal cancer is most often based on computer tomography (CT), but there is a trend to increase the use of magnetic resonance imaging (MRI) [8] . The gold standard for local tumor staging already includes MRI.…”

Section: Introductionmentioning

confidence: 99%