Colorectal Cancer: Imaging Conundrums

Progressive technologic advancements in imaging have significantly improved the preoperative sensitivity for the detection of very small foci of regionally or hematogenously metastatic colorectal cancer. Unfortunately, this information has not translated to continued linear gains in patient survival and might even result in the false-positive upstaging of some cases: these are two conundrums in the imaging of colorectal cancer. Both conundrums might be resolved by the widespread use of real-time imaging guidance during operative procedures, and this might open the way for the widespread use of fluorodeoxyglucose PET/CT for the initial staging of patients with colorectal cancer.