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Chapter 9 - Gastrointestinal tract

from Part II - Oncologic applications

Published online by Cambridge University Press:  05 September 2012

Victor H. Gerbaudo
Affiliation:
Brigham and Women's Hospital, Harvard Medical School
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Summary

Introduction

In this chapter, the approach to gastrointestinal tumors will be discussed. Here we limit ourselves to colorectal cancer (CRC), stomach or gastric cancer, and GIST (gastrointestinal stromal tumor) sarcoma. Chapter 8 expands on esophageal cancer. Pancreas, liver, and biliary tract malignancies are discussed in Chapter 10.

Advances in diagnostic imaging technology have improved establishing the diagnosis, staging and restaging of disease, and monitoring response to therapy. Various imaging modalities are available for this purpose, including the anatomical, e.g., radiography, computed tomography (CT), sonography (US), magnetic resonance imaging (MRI), and functional modalities such as molecular imaging, radioimmuno- and receptor scintigraphy, and magnetic resonance spectroscopy.

Conventional diagnostic methods have limited accuracy in early detection of primary as well as recurrent CRC and gastric carcinoma. Assessment of disease extent or tumor burden is necessary for proper patient selection for surgery with curative intent, or stratification to chemotherapy and/or radiation treatment for patients with advanced disease. Appropriate non-invasive staging plays a pivotal role in patient management. Integrated modalities such as positron emission tomography/ computed tomography (PET/CT) have changed the current work-up of patients with cancer (1). Some refer to these combined gantries as dual, multimodality or hybrid imaging systems.

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Publisher: Cambridge University Press
Print publication year: 2012

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