Positron Emission Tomography Applications in Gastrointestinal Cancer Management
Summary
Positron emission tomography (PET), most commonly with the glucose analogue [18F]fluorodeoxyglucose (FDG), has become an integral tool in the management of gastrointestinal malignancies. By combining functional metabolic information with anatomical detail—often via hybrid PET/CT—clinicians are able to detect primary tumours, delineate locoregional lymphadenopathy and uncover distant metastases with high sensitivity. In oesophagogastric cancer, routine FDG PET/CT staging can reveal occult metastatic deposits, refine surgical candidacy and predict early recurrence. In colorectal cancer, quantitative PET metrics such as maximum standardised uptake value (SUVmax), metabolic tumour volume and total lesion glycolysis correlate with histopathological aggressiveness, guide neoadjuvant chemotherapy decisions and aid in the detection of recurrent disease. Beyond standardised uptake measures, emerging radiomic analyses extract high-dimensional features that improve nodal staging accuracy and enable personalised risk stratification. Novel PET tracers targeting hypoxia, amino acid transport or receptor expression are extending the modality’s reach into tailored theranostics and response assessment of immunotherapy. Despite challenges of cost, access and variability in tracer uptake, PET remains central to multidisciplinary decision-making, supporting global efforts to harmonise imaging protocols and integrate molecular phenotyping into clinical pathways for patients with gastrointestinal cancer.
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Positron Emission Tomography Applications in Gastrointestinal Cancer Management publication trend
The graph below shows the total number of articles in positron emission tomography applications in gastrointestinal cancer management across all publications each year (not limited to Nature Index journals).
Technical terms
Positron emission tomography (PET): A functional imaging technique that detects pairs of gamma photons emitted indirectly by a positron-emitting radionuclide tracer to map metabolic activity within the body.
[18F]fluorodeoxyglucose (FDG): A glucose analogue labelled with fluorine-18, preferentially taken up by cells with high glycolytic rates, such as many cancer cells.
Standardised uptake value (SUV): A semiquantitative measure of tracer uptake in a region of interest, normalised to injected dose and patient body metrics.
Radiomics: The extraction and analysis of large numbers of quantitative features from medical images, enabling advanced pattern recognition and predictive modelling.
Lymph node metastasis: The spread of cancer cells from a primary tumour to regional lymph nodes, crucial for accurate staging and management decisions.
References
- BATF promotes tumor progression and association with FDG PET-derived parameters in colorectal cancer. Journal of Translational Medicine (2024).
- Routinely staging gastric cancer with 18F-FDG PET-CT detects additional metastases and predicts early recurrence and death after surgery. European Radiology (2019).
- Imaging in Colorectal Cancer: Progress and Challenges for the Clinicians. Cancers (2016).
- 18F-FDG PET/CT Radiomics for Preoperative Prediction of Lymph Node Metastases and Nodal Staging in Gastric Cancer. Frontiers in Oncology (2021).
- PET/CT for Predicting Occult Lymph Node Metastasis in Gastric Cancer. Current Oncology (2022).
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