Role of (18F) 2-fluoro-2-deoxyglucose positron emission tomography in upper gastrointestinal malignancies Journal Article
| Authors: | Smyth, E. C.; Shah, M. A. |
| Article Title: | Role of (18F) 2-fluoro-2-deoxyglucose positron emission tomography in upper gastrointestinal malignancies |
| Abstract: | The role of whole-body FDG [(18F) 2-fluoro-2-deoxyglucose] positron emission tomography (PET) scanning as an imaging modality in the management of patients with malignancy has evolved enormously over the past two decades. FDG-PET has demonstrated significant efficacy in the staging, prognostication and detection of occult metastatic disease in malignancies of the gastrointestinal tract, in addition to assessment of the response to cytotoxic chemotherapy in a more timely manner than has traditionally been possible by more conventional imaging tools. The sensitivity and specificity of FDG-PET for the detection and staging of malignancy depend not only on the site and size of the primary tumor and metastases, but also on histological cell type, reflecting underlying disparities in glucose metabolism. The metabolic response to neo-adjuvant chemotherapy or to chemo-radiotherapy in cancers of the gastro-esophageal junction or stomach has been demonstrated in several prospective studies to correlate significantly with both the histological tumor response to treatment and with consequent improvements in overall survival. This may offer a future paradigm of personalized treatment based on the PET response to chemotherapy. FDG-PET has been less successful in efforts to screen for and detect recurrent upper gastrointestinal malignancies, and in the detection of low volume metastatic peritoneal disease. Efforts to improve the accuracy of PET include the use of novel radiotracers such as (18F) FLT (3-deoxy-3-fluorothymidine) or 11C-choline, or fusion PET-CT with concurrent high-resolution computed tomography. This review focuses on the role of FDG-PET scanning in staging and response assessment in malignancies of the upper gastrointestinal tract, specifically gastric, esophageal and pancreas carcinoma. © 2011 Baishideng. All rights reserved. |
| Keywords: | cancer chemotherapy; cancer survival; event free survival; treatment response; primary tumor; overall survival; review; cisplatin; cytotoxic agent; fluorouracil; advanced cancer; treatment planning; bone metastasis; cancer adjuvant therapy; pancreas cancer; cancer staging; nuclear magnetic resonance imaging; positron emission tomography; recurrent cancer; lymph node metastasis; antineoplastic agent; diagnostic accuracy; sensitivity and specificity; cancer palliative therapy; ki 67 antigen; c reactive protein; computer assisted tomography; multiple cycle treatment; tumor volume; differential diagnosis; cancer screening; diagnostic imaging; prediction; histology; distant metastasis; cell type; irinotecan; digestive system cancer; pancreas carcinoma; liver metastasis; early cancer; chronic pancreatitis; cancer size; fluorodeoxyglucose f 18; pancreas adenocarcinoma; stomach cancer; glucose; preoperative treatment; esophagus cancer; esophageal adenocarcinoma; stomach adenocarcinoma; 3' fluorothymidine f 18; choline c 11; peritoneum metastasis; radiodiagnosis; stomach carcinoma; esophagus carcinoma; upper gastrointestinal tract; esophagus tumor; chemoradiotherapy; esophageal cancer; esophageal squamous cell carcinoma; endoscopic echography; lower esophagus sphincter; glucose transporter 1; personalized medicine; gastric cancer; whole body pet; glucose metabolism; upper gastrointestinal tract cancer |
| Journal Title: | World Journal of Gastroenterology |
| Volume: | 17 |
| Issue: | 46 |
| ISSN: | 1007-9327 |
| Publisher: | Baishideng Publishing Group Inc |
| Date Published: | 2011-12-14 |
| Start Page: | 5059 |
| End Page: | 5074 |
| Language: | English |
| DOI: | 10.3748/wjg.v17.i46.5059 |
| PROVIDER: | scopus |
| PMCID: | PMC3235589 |
| PUBMED: | 22171140 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 3 January 2012" - "CODEN: WJGAF" - "Source: Scopus" |
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