Utility of positron emission tomography/CT in the evaluation of small bowel pathology

Department of Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, Boston, MA, USA.
The British journal of radiology (Impact Factor: 2.03). 09/2012; 85(1017):1211-21. DOI: 10.1259/bjr/64534573
Source: PubMed


We describe the management principles and different roles of positron emission tomography (PET)/CT in the evaluation of patients with small bowel tumours (adenocarcinoma, gastrointestinal stromal tumour, lymphoma, metastases) from initial staging, monitoring response to treatment, to detection of recurrent disease. We also discuss the various non-malignant aetiologies of small bowel fludeoxyglucose (FDG) PET uptake, and other pitfalls in FDG PET/CT interpretation. Awareness of the imaging appearances of small bowel tumours, patterns of disease spread and potential PET/CT interpretation pitfalls are of paramount importance to optimise diagnostic accuracy.

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    • "Bowel wall segments with homogenous thickening > 2 cm with a normal or enlarged lumen should necessitate further evaluation and biopsy as should mesenteric nodal masses[5,6]. PET (Positron emission tomography) scan findings vary depending and there is very little data with regard to its usefulness in the detection of gastrointestinal lymphomas and FDG activity may also related to inflammatory conditions and infections[12]. Colonoscopy with TI intubation of the terminal ileum can be revealing as well as push enteroscopy for the detection of proximal small bowel lesions, with biopsy of lesions which can be diagnostic. In one case study patients diagnosed by endoscopy were alive for more than 14 months with diagnosis by DBE (double balloon enteroscopy) followed by DBE during chemotherapy[11]. "

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