Colorectal cancer (CRC) incidence and mortality rates are extremely variable around the world. CRC is the second most commonly diagnosed cancer in both genders [1]. Many patients are cured with initial surgery for primary disease and postoperative chemotherapy. Nevertheless, recurrent locoregional or distant metastases occur in approximately 40% of patients with stage II and stage III CRC [2]. A significant proportion of CRC recurrences occur in a single location, such as pelvis, liver, or lung [3, 4]. Surgery may be curative in some patients with localized recurrent disease and has an impact on 5-year overall survival (OS), which is 27% among patients who undergo surgery vs. 6% in patients who do not [3, 4]. Therefore, accurate and early identification of recurrent and/or metastatic disease is a critical and challenging issue in terms of improving OS of CRC patients. The measurement of circulating carcinoembryonic antigen (CEA) is the most widely accepted test in clinical practice for screening for recurrent CRC. Additionally, periodic colonoscopy, ultrasound (US), and multi-detector computed tomography (MDCT) for localization of recurrent CRC in the early stages are often performed during follow-up. None of these imaging modalities is extremely accurate [5].