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Gastrointestinal

  • Roland Hustinx
Part of the Medical Radiology book series (MEDRAD)

Abstract

PET-CT combines in a single imaging session both anatomical and metabolic information. Depending on the strategy, the CT part of the study may yield only crude anatomical information and attenuation correction for the PET part, or it may offer full radiological diagnostic features. Regarding the radiotracers for gastrointestinal oncology, FDG remains the mainstay but alternative compounds aimed at more specific biological targets are actively tested. In particular Ga-68-labelled DOTA derivatives image somastostatin receptors with exquisite sensitivity and specificity. In clinical practice, several indications are well recognized for FDG PET-CT. These include the initial staging of esophageal, pancreatic and rectal cancers with a clinical impact in a significant proportion of patients. The metabolic activity, as recorded prior to any treatment, holds prognostic information in esophageal cancer and hepatocarcinomas. Furthermore, the metabolic response assessed early on during chemotherapy and/or radiotherapy may be very valuable in esophageal and rectal cancers, as well as in GISTs. Methodological issues remain to be solved, but the potential is clearly present so that an increased clinical role is highly likely in the near future. FDG PET-CT is a major clinical tool in the detection and staging of recurrent colorectal cancer, and for determining the resectability of liver metastases. Ongoing developments include technological advances, in particular the combined PET-MR devices, and alternative tracers, such as those imaging angiogenesis.

Keywords

Pancreatic Cancer Rectal Cancer Liver Metastasis Neuroendocrine Tumor Tumor Metabolic Volume 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg  2011

Authors and Affiliations

  1. 1.Division of Nuclear MedicineUniversity Hospital of LiègeLiège 1Belgium

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