Previous limited studies of the vascular-metabolic phenotype in colorectal cancer with perfusion CT and 18F-FDG PET have noted that tumors with a lower perfusion-metabolic ratio demonstrate higher VEGF and HIF-1 alpha expression [18]; and a combination of metabolic activity, permeability and perfusion may inform on outcome [19], but have not assessed response to neoadjuvant therapy. This evidence concerns the gene VEGFA and colorectal cancer.