结直肠癌（CRC）是一个重大的全球健康问题。使用不同方式的诊断成像在结直肠癌从早期检测（即筛查）到随访的过程中发挥着关键作用。影像学在 CRC 筛查中的作用取决于每个国家的方法：如果制定了有组织的筛查计划，则 CT 结肠成像 (CTC) 的作用仅限于对粪便测试呈阳性且不愿意/无法接受结肠镜检查的个体进行研究。 CC）或不完全CC的患者。虽然 CC 是诊断 CRC 最常见的方式，但在常规腹部影像检查或急诊室出现肠闭塞/亚闭塞或穿孔的患者中也可能偶然发现 CRC。分期是 CRC 管理的一个重要方面，可指导治疗决策并提供有价值的预后信息。对于直肠癌和结肠癌，必须进行准确的局部分期，以推动适当的治疗工作流程。 FDG PET/CT 可以部分解决 US、CT 和 MR 在 N 分期中的重要局限性。远端分期通常通过 CT 进行管理，MR 和 FDG PET/CT 可用作解决问题的技术。随访是根据肿瘤学会的一般建议进行的。临床相关性声明：有必要总结结直肠癌检查的每个阶段，在主要国际指南和文献数据的支持下区分结肠癌和直肠癌的治疗，目的是向社区通报结直肠癌影像学的最佳实践。要点： • 结直肠癌是一种流行病，在检测和治疗的每个阶段都需要进行影像学检查。 • 各种成像方式可用作直接可视化筛查方法的辅助或替代方法，并且对于评估转移性疾病是必要的。 • 应根据患者的个体复发风险考虑重新评估随访策略。© 2024。作者。

Colorectal cancer (CRC) is a significant global health concern. Diagnostic imaging, using different modalities, has a pivotal role in CRC, from early detection (i.e., screening) to follow-up. The role of imaging in CRC screening depends on each country's approach: if an organized screening program is in place, the role of CT colonography (CTC) is limited to the study of either individuals with a positive stool test unwilling/unable to undergo colonoscopy (CC) or in patients with incomplete CC. Although CC is the most common modality to diagnose CRC, CRC can be also incidentally detected during a routine abdominal imaging examination or at the emergency room in patients presenting with intestinal occlusion/subocclusion or perforation. Staging is a crucial aspect of CRC management, guiding treatment decisions and providing valuable prognostic information. An accurate local staging is mandatory in both rectal and colon cancer to drive the appropriate therapeutic workflow. Important limitations of US, CT, and MR in N-staging can be partially solved by FDG PET/CT. Distant staging is usually managed by CT, with MR and FDG PET/CT which can be used as problem-solving techniques. Follow-up is performed according to the general recommendations of the oncological societies. CLINICAL RELEVANCE STATEMENT: It is essential to summarize each phase of colorectal cancer workup, differentiating the management for colon and rectal cancer supported by the main international guidelines and literature data, with the aim to inform the community on the best practice imaging in colorectal cancer. KEY POINTS: • Colorectal cancer is a prevalent disease that lends itself to imaging at each stage of detection and management. • Various imaging modalities can be used as adjuncts to, or in place of, direct visualization methods of screening and are necessary for evaluating metastatic disease. • Reevaluation of follow-up strategies should be considered depending on patients' individual risk of recurrence.© 2024. The Author(s).