In colorectal cancer (CRC), imaging is important in determining tumor stage, selecting treatment strategies, and in assessing response to therapy. However, some challenges remain with established imaging techniques, such as computed tomography, and with some commonly used response criteria, such as Response Evaluation Criteria in Solid Tumors, which measures change in size of several target lesions instead of change in tumor morphology or metabolic function. In addition, these assessments are not typically conducted until after 8 weeks of treatment, meaning that potential non-responders are often not identified in a timely manner. Regorafenib, an oral tyrosine kinase inhibitor indicated for the treatment of metastatic CRC, blocks the activity of several protein kinases involved in angiogenesis, oncogenesis, metastasis, and tumor immunity. Timely differentiation of regorafenib responders from non-responders using appropriate imaging techniques that recognize not only changes in tumor size but also changes in tumor density or vasculature, may reduce unnecessary drug-related toxicity in patients who are unlikely to respond to treatment. This review discusses the latest developments in computed tomography, magnetic resonance imaging, and positron emission tomography tumor imaging modalities, and how these aid in identifying patients with metastatic CRC who are responders or non-responders to regorafenib treatment.

中文翻译：

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瑞格非尼在转移性结直肠癌中的影像学和临床相关性。

在结直肠癌（CRC）中，成像对于确定肿瘤分期，选择治疗策略以及评估对治疗的反应非常重要。然而，成熟的成像技术（例如计算机断层扫描）以及一些常用的响应标准（例如实体瘤的响应评估标准）仍然存在一些挑战，该标准可测量多个目标病变的大小变化而不是肿瘤形态或代谢功能的变化。此外，这些评估通常要等到治疗8周后才能进行，这意味着往往无法及时识别潜在的无反应者。Regorafenib是一种口服酪氨酸激酶抑制剂，可用于转移性CRC的治疗，可阻断涉及血管生成，肿瘤发生，转移和肿瘤免疫力的几种蛋白激酶的活性。使用适当的成像技术及时区分regorafenib应答者与非应答者，不仅可以识别肿瘤大小的变化，还可以识别肿瘤密度或脉管系统的变化，可以减少不太可能对治疗产生反应的患者不必要的药物相关毒性。这篇综述讨论了计算机断层扫描，磁共振成像和正电子发射断层扫描肿瘤成像模式的最新进展，以及这些方法如何帮助确定对瑞格非尼治疗有反应或无反应的转移性CRC患者。可能会减少不太可能对治疗产生反应的患者不必要的药物相关毒性。这篇综述讨论了计算机断层扫描，磁共振成像和正电子发射断层扫描肿瘤成像模式的最新进展，以及这些方法如何帮助确定对瑞格非尼治疗有反应或无反应的转移性CRC患者。可能会减少不太可能对治疗产生反应的患者不必要的药物相关毒性。这篇综述讨论了计算机断层扫描，磁共振成像和正电子发射断层扫描肿瘤成像模式的最新进展，以及这些方法如何帮助确定对瑞格非尼治疗有反应或无反应的转移性CRC患者。