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Gastrointestinal malignancies in pregnancy

  • Special Section: Cancer in Pregnancy
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Gastrointestinal malignancies, though uncommon in pregnancy, present several unique challenges with regards to diagnosis, staging, and treatment. Imaging the pregnant patient with a suspected or confirmed GI malignancy requires modifications to the radiologic modality of choice and protocol in order to minimize harm to the fetus, ensure accuracy in diagnosis and staging and guide treatment decisions. In this review article, we discuss the imaging approach to the pregnant patient with GI cancer, including safe radiologic modalities and modifications to imaging protocols. We also review the most common GI cancers encountered in pregnancy, including colorectal, pancreatic, gastric, and small bowel tumors, with emphasis to imaging findings, staging, and treatment considerations.

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Abbreviations

GI:

Gastrointestinal

US:

Ultrasound

FDG PET/CT:

Fluoro-2-deoxyglucose positron emission tomography

CRC:

Colorectal cancer

CEA:

Carcinogen embryonic antigen

DWI:

Diffusion-weighted imaging

PDAC:

Pancreatic adenocarcinoma

NET:

Neuroendocrine tumors

MCN:

Mucinous cystic neoplasms

SPN:

Solid pseudopapillary neoplasms

PNET:

Pancreatic neuroendocrine tumors

EUS:

Endoscopic ultrasound

ERCP:

Endoscopic retrograde cholangiopancreatography

FNA:

Fine needle aspiration

MRCP:

Magnetic resonance cholangiopancreatography

HL:

Hodgkin’s lymphoma

NHL:

Non-Hodgkin's lymphoma

HAART:

Highly active antiretroviral therapy

MALT:

Lymphoma of mucosa-associated lymphoid tissue

H.Pylori:

Helicobacter pylori

GIST:

Gastrointestinal stromal tumor

EGD:

Esophagogastroduodenoscopy

SSFSE:

Single Shot Fast Spin Echo

IP-OOP:

In Phase and Opposed Phase

FS:

Fat Saturated

FSE:

Fast Spin Echo

SSFP:

Steady-state Free Procession

FOLFOX:

Fluorouracil, folinic acid, and oxaliplatin

FOLFIRI:

Fluorouracil, folinic acid, and irinotecan

FOLFOXIRI:

Fluorouracil, oxaliplatin, and irinotecan

FOLFIRINOX:

Folinic acid, fluorouracil, oxaliplatin, and irinotecan

CHOP:

Cyclophosphamide, doxorubicin, vincristine, and prednisone

ABVD:

Doxorubicin, bleomycin, vinblastine, and dacarbazine

PDGF:

Platelet-derived growth factor

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Authors and Affiliations

  1. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA

    Melina Pectasides & Aarti Sekhar

  2. Department of Radiology, University of Washington Medical Center, Seattle, WA, USA

    Manjiri K. Dighe

  3. Department of Radiology, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Gillis Schwartz & Jeanne M. Horowitz

  4. Department of Abdominal Imaging and Nuclear Medicine, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA

    Shetal N. Shah

  5. Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Mary F. Mulcahy

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  1. Melina Pectasides
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  2. Aarti Sekhar
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  3. Manjiri K. Dighe
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  4. Gillis Schwartz
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Correspondence to Melina Pectasides.

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Pectasides, M., Sekhar, A., Dighe, M.K. et al. Gastrointestinal malignancies in pregnancy. Abdom Radiol 48, 1709–1723 (2023). https://doi.org/10.1007/s00261-022-03788-8

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