Positron emission tomography (PET) and other nuclear medicine modalities in staging gastrointestinal cancer

Abstract

Gastrointestinal (GI) cancers account for the second highest number of new tumor cases and deaths per year in the United States and Western Europe. The most frequently involved sites are, in descending order, the colorectum, stomach, pancreas, liver, bile duct, and esophagus. The most common tumor type is adenocarcinoma. Among the epithelial cancers, great attention has recently been given to the tumors of neuroendocrine origin. These concepts are relevant because nuclear medicine imaging is based on visualization by means of a particular uptake of radiolabelled tracers in cancer cells that concentrate the radioactive signal. This signal is detected and reconstructed in planar or tomographic images. Different radiopharmaceuticals have been proposed for diagnostic application in oncology (such as radiolabelled monoclonal antibodies (MAbs), receptor tracers, and positron-emitting radiopharmaceuticals), and they are currently used as tracers for tumor detection with different modalities and techniques. Most of these techniques demonstrate their clinical usefulness in the diagnosis of GI cancer. This work is not intended to be a comprehensive review of all the extensive experience and possibilities of nuclear medicine for the diagnosis of GI tumors; rather, it aims to summarize the current status of the most important approaches and their main indications in staging GI cancers.

Non-natural amino acids for tumor imaging using positron emission tomography and single photon emission computed tomography

“…The combination of anatomical images from CT and/or MRI with metabolic information obtained from FDG-PET has improved the diagnostic evaluation of a number of human malignancies [1][2][3][4][5][6]. [ 18 F]FDG enters cells via plasma membrane glucose transporters, undergoes phosphorylation at the first step of the glycolytic pathway and is then irreversibly trapped intracellularly in most tissues.…”

Using 18F-Fluorodeoxyglucose Positron Emission Tomography to Monitor Clinical Outcomes in Patients Treated With Neoadjuvant Chemo-Radiotherapy for Locally Advanced Pancreatic Cancer

“…It has both high sensitivity and specificity making it a useful tool in the diagnosis and staging of cancer patients. (6-8) Its reproducibility for quantitative metabolic measurements has been validated in malignant tumors. (9;10) PET is approved for use in the United States for cancer patients with breast, esophageal, lung, head and neck, lymphoma, thyroid, colorectal, and melanoma.…”

Prospective Evaluation of Positron Emission Tomography in the Preoperative Staging of Esophageal Carcinoma

“…P OSITRON EMISSION TOMOGRAphy (PET) is a noninvasive diagnostic procedure with a high specificity rate in the demonstration of metabolically active tumor tissue in the entire body. [1][2][3] The preoperative diagnosis of distant metastases in patients with esophageal carcinoma using PET enabled the identification of distant metastases that were not detected with standard computed tomography (CT). [4][5][6][7][8][9][10][11][12][13] Positron emission tomography has therefore been suggested as the most appropriate modality in the selection of patients for resection therapy.…”