Clinical impact of FDG PET/CT in alimentary tract malignancies: an updated review

• Published in: Abdominal radiology (New York) Vol. 45; no. 4; pp. 1018 - 1035
• Main Authors: Akin, Esma A., Qazi, Zain N., Osman, Murat, Zeman, Robert K.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-04-2020
• Subjects: CME articles; Digestive System Neoplasms - diagnostic imaging; Digestive System Neoplasms - pathology; Digestive System Neoplasms - therapy; Fluorodeoxyglucose F18; Gastroenterology; Hepatology; Humans; Imaging; Medicine; Medicine & Public Health; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Radiology; Radiopharmaceuticals; Review; FDG; Malignancy; Colorectal; Gastric malignancy; PET/CT; Esophageal malignancy
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-020-02447-0

The use of
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F-fluorodeoxyglucose (FDG) positron emission tomography combined with computed tomography (PET/CT) is well established in the evaluation of alimentary tract malignancies. This review of the literature and demonstration of correlative images focuses on the current role of PET/CT in the diagnosis (including pathologic/clinical staging) and post-therapy follow-up of esophageal, gastric, and colorectal cancers. PET/CT provides utility in the management of esophageal cancer, including detection of distant disease prior to resection. In gastric cancer, PET/CT is useful in detecting solid organ metastases and in characterizing responders vs. non-responders after neoadjuvant chemotherapy, the latter of which have poorer overall survival. In patients with GIST tumors, PET/CT also determines response to imatinib therapy with greater expedience as compared to CECT. For colorectal cancer, PET/CT has proven helpful in detecting hepatic and other distant metastases, treatment response, and differentiating post-radiation changes from tumor recurrence. Our review also highlights several pitfalls in PET/CT interpretation of alimentary tract lesions.