MINI REVIEW article
Front. Physiol.
Sec. Computational Physiology and Medicine
This article is part of the Research TopicMedical Knowledge-Assisted Machine Learning Technologies in Individualized Medicine Volume IIIView all articles
A New Paradigm in Postoperative Colorectal Cancer Surveillance: Integrating Advanced Imaging and Multi-omics
Provisionally accepted
Dongxue Yu1
Jiandong Tai2,3*- 1The Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Changchun, China
- 2First Affiliated Hospital of Jilin University, Changchun, China
- 3Changchun University of Traditional Chinese Medicine, Changchun, China
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Up to one-third of patients with localized colorectal cancer (CRC) relapse after curative-intent resection, as conventional markers like carcinoembryonic antigen (CEA) and scheduled CT/MRI often fail to detect micro-metastatic disease early. Advanced imaging, particularly radiomics, and liquid biopsy with circulating tumor DNA (ctDNA) are emerging as complementary tools to address this challenge. Radiomics extracts high-throughput image features to quantify risk and track response, with reported AUCs often ranging from 0.70-0.85. Concurrently, ctDNA has proven to be the strongest postoperative prognostic marker for recurrence in stage II-III CRC, providing surveillance lead times of 3-11 months over conventional methods. The landmark DYNAMIC trial demonstrated that ctDNA-guided adjuvant therapy safely reduced chemotherapy uses without compromising survival. By integrating ctDNA's temporal "signal" with imaging's spatial "localization," clinicians can accelerate the detection of oligometastatic relapse, personalize surveillance, and refine treatment monitoring. This review synthesizes the evidence supporting this integrated approach, outlining the path toward a proactive, precision-based standard of care in postoperative CRC management, while also addressing the key challenges of standardization and clinical validation that must be overcome.
Keywords: colorectal cancer, Minimal residual disease (MRD), multi-omics, Postoperative surveillance, Radiomics
Received: 01 Dec 2025; Accepted: 15 Dec 2025.
Copyright: © 2025 Yu and Tai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiandong Tai
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