ACR Appropriateness Criteria® Staging of Colorectal Cancer: 2021 Update

• Published in: Journal of the American College of Radiology Vol. 19; no. 5; pp. S208 - S222
• Main Authors: Korngold, Elena K., Moreno, Courtney, Kim, David H., Fowler, Kathryn J., Cash, Brooks D., Chang, Kevin J., Gage, Kenneth L., Gajjar, Aakash H., Garcia, Evelyn M., Kambadakone, Avinash R., Liu, Peter S., Macomber, Meghan, Marin, Daniele, Pietryga, Jason A., Santillan, Cynthia S., Weinstein, Stefanie, Zreloff, Jennifer, Carucci, Laura R.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2022
• Subjects: Appropriate Use Criteria; Appropriateness Criteria; AUC; Colon cancer staging; Colonic Neoplasms; Colorectal neoplasms; Diagnostic Imaging - methods; Humans; Neoadjuvant Therapy; Rectal cancer staging; Rectal Neoplasms; Societies, Medical; United States; United States; Neoadjuvant therapy; Colon cancer staging; Rectal cancer staging; Appropriate Use Criteria; Colorectal neoplasms; Colonic neoplasms; Rectal neoplasms; Appropriateness Criteria; AUC
• ISSN: 1546-1440; 1558-349X
• DOI: 10.1016/j.jacr.2022.02.012

Preoperative imaging of rectal carcinoma involves accurate assessment of the primary tumor as well as distant metastatic disease. Preoperative imaging of nonrectal colon cancer is most beneficial in identifying distant metastases, regardless of primary T or N stage. Surgical treatment remains the definitive treatment for colon cancer, while organ-sparing approach may be considered in some rectal cancer patients based on imaging obtained before and after neoadjuvant treatment. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.