Imaging oligometastatic cancer before local treatment.

Abstract

The term oligometastases is in common clinical use, but remains poorly defined. As novel treatment strategies widen the therapeutic window for patients defined as having oligometastatic cancer, improved biomarkers to reliably define patients who benefit from these treatments are needed. Multimodal imaging should be optimized to comprehensively assess the metastatic sites, disease burden and response to neoadjuvant treatment in each disease setting. These features will likely remain important prognostic biomarkers, and are critical in planning multidisciplinary treatment. There are opportunities to extract additional phenotypic information from conventional imaging, while novel imaging techniques can also image specific aspects of tumour biology. Imaging can both characterise and localise the phenotypic heterogeneity of multiple tumour sites. Novel approaches to existing imaging datasets, and correlation with tumour biology, will be important in realizing the potential of imaging to guide treatment in the oligometastatic setting. This article discusses the current status and future directions of imaging in patients with extracranial oligometastases.