Abstract
Simple SummaryThe imaging of oligometastatic disease (OMD) is challenging as it requires precise loco-regional staging and whole-body assessment. The combination of imaging modalities is often required. The more accurate imaging tool will be selected according to tumor type, the timing with regard to measurement and treatment, metastatic location, and the patient’s individual risk for metastasis. The most commonly used modalities are contrast-enhanced computed tomography (CT), magnetic resonance imaging and metabolic and receptor-specific imaging, particularly, 18F-fluorodesoxyglucose positron emission tomography/CT, used alone or in combination.Oligometastatic disease (OMD) is an emerging state of disease with limited metastatic tumor burden. It should be distinguished from polymetastatic disease due the potential curative therapeutic options of OMD. Imaging plays a pivotal role in the diagnosis and follow-up of patients with OMD. The imaging tools needed in the case of OMD will differ according to different parameters, which include primary tumor type, timing between measurement and treatment, potential metastatic location and the patient’s individual risk for metastasis. In this article, OMD is defined and the use of different imaging modalities in several oncologic situations are described in order to better understand OMD and its specific implication for radiologists.
Highlights
Oligometastatic disease (OMD) was first described by Hellman et al in 1995 [1] as an intermediate stage between localized tumor and widely polymetastatic disease (PMD).This first definition was mainly based on the number of metastatic lesions, which ranged from one to five
Imaging plays a key role in differentiating OMD from PMD
Imaging plays a key role in differentiating OMD from PMD and selecting patients who can potentially benefit from a curative treatment
Summary
Oligometastatic disease (OMD) was first described by Hellman et al in 1995 [1] as an intermediate stage between localized tumor and widely polymetastatic disease (PMD) This first definition was mainly based on the number of metastatic lesions, which ranged from one to five. Oligo-progressive disease has been described in patients with lung cancer treated with targeted therapy or immunotherapy [4–6] and is felt to be a consequence of tumor heterogeneity and the development of isolated resistant subclones at only one or a few metastatic sites [7] In this narrative review, we provide an overview of the different imaging methods for the diagnostic and the pre-therapeutic work up of OMD. Morphological imaging is usually more useful in early stages, while at later stages, when changes due to treatment are present, the interest of functional imaging including magnetic resonance imaging (MRI) with diffusion weighed imaging (DWI) or positron emission tomography (PET) is growing [8]
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