Role of ( 18F) 2-fluoro-2-deoxyglucose positron emission tomography in upper gastrointestinal malignancies Review uri icon

Overview

MeSH Major

  • Esophageal Neoplasms
  • Fluorodeoxyglucose F18
  • Pancreatic Neoplasms
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Stomach Neoplasms

abstract

  • The role of whole-body FDG [((18)F) 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 ((18)F) FLT (3-deoxy-3-fluorothymidine) or (11)C-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.

publication date

  • December 14, 2011

Research

keywords

  • Review

Identity

Language

  • eng

PubMed Central ID

  • PMC3235589

Digital Object Identifier (DOI)

  • 10.3748/wjg.v17.i46.5059

PubMed ID

  • 22171140

Additional Document Info

start page

  • 5059

end page

  • 74

volume

  • 17

number

  • 46