Positron emission tomography in neoplasms of the digestive system

Jasna Mihailović, Leonard M. Freeman

Research output: Contribution to journalArticle

Abstract

PET/CT has proven to be extremely useful in studying neoplasms of the colon and esophagus. It has been less promising for lesions of the stomach, pancreas and hepatobiliary tract. Colorectal cancer is the third most common non-cutaneous cancer representing 13% of all malignancies. The use of colonoscopy has significantly contributed to the earlier detection and higher cure rate. PET/CT is not a screening procedure. It is very good for staging, recurrence detection and monitoring therapeutic interventions. It is excellent for detecting distant metastases, e.g. liver lesions, but is less accurate for detecting nodal involvement. The CT portion of the study enhances certainty of lesion localization and characterization. Esophageal cancer is less common in the U.S. in that it represents 7% of G-I cancers, but only 1% of all cancers. The major problem is that often it is advanced to Stages III or IV before it comes to clinical recognition. A 5-year survival has been improved from 3% to 10% by the use of induction chemoradiotherapy. PET has proven useful in staging and determining resectability, monitoring response to therapy, radiotherapy treatment planning and distinguishing between postop scar and residual or recurrent disease on CT. Gastric cancer results have been more variable. The intestinal (tubular variety) shows better uptake than the non-intestinal (signet ring cell) variety because of the greater mucous content of the latter which is associated with more false negatives. FDG uptake in pancreatic cancer is also variable. Attempts at distinguishing carcinoma from pancreatitis have been limited. When lesions do show uptake, PET/CT has been helpful in monitoring therapeutic interventions. Hepatocellular cancer demonstrates significant FDG uptake in only 50-70% of cases. Cholangio carcinomas; particularly the peripheral variety, do show significant FDG uptake.

Original languageEnglish (US)
Pages (from-to)86-93
Number of pages8
JournalArchive of Oncology
Volume20
Issue number3-4
DOIs
StatePublished - Dec 2012

Fingerprint

Digestive System Neoplasms
Positron-Emission Tomography
Esophageal Neoplasms
Neoplasms
Carcinoma
Chemoradiotherapy
Colonoscopy
Therapeutics
Liver Neoplasms
Pancreatic Neoplasms
Pancreatitis
Colonic Neoplasms
Stomach Neoplasms
Cicatrix
Pancreas
Colorectal Neoplasms
Stomach
Radiotherapy
Neoplasm Metastasis
Recurrence

Keywords

  • Carcinoma
  • Colorectal neoplasms
  • Esophageal neoplasms
  • Gastrointestinal neoplasms
  • Hepatocellular
  • Pancreatic neoplasms
  • Positron-emission tomography and computed tomography
  • Stomach neoplasms

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Positron emission tomography in neoplasms of the digestive system. / Mihailović, Jasna; Freeman, Leonard M.

In: Archive of Oncology, Vol. 20, No. 3-4, 12.2012, p. 86-93.

Research output: Contribution to journalArticle

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