Gastrointestinal cancer

Definition Gastrointestinal cancer (GI) occurs when there are uncontrolled, abnormal cells growing in the . GI cancers can appear anywhere along the long twisting tube that includes the , , small and (which includes the colon), rectum and anus (Discovermi.org - SNM, 2011).

Role of molecular imaging Molecular imaging has become an essential tool in the diagnosis, evaluation and treatment of patients with gastrointestinal cancers. Positron emission tomography (PET) and PET combined with computed tomography (PET/CT) are used to diagnose the disease and monitor treatment. PET/CT imaging is used in various forms of GI cancers:

 Gastric cancer (Discovermi.org - SNM, 2011) o To determine response to therapy  Small bowel tumors (Discovermi.org - SNM, 2011) o To diagnose and monitor the treatment  Esophageal, pancreatic and gastric (stomach) cancers o To pinpoint the location of the spread of cancer  GI lymphoma (Discovermi.org - SNM, 2011) o To establish size, level of progression and stage o To monitor response to treatment for Hodgkin’s and non-Hodgkin's lymphoma o To distinguish whether there has been a recurrence  o Assess level of disease progression and whether metastasis is present (SNM, 2009) o Helps monitor effectiveness of treatment (SNM, 2009) o Distinguish whether there has been a recurrence at completion of treatment (SNM, 2009) o Provides valuable information for physicians to make better informed decisions on patient management (SNM, 2009)

Approved indications in adults Radiopharmaceutical Manufacturer Trade names (pediatric use as noted)

Fluorine-18 As a PET imaging agent to: Various fluorodeoxyglucose  Assess abnormal glucose metabolism

An agent for the scintigraphic localization of Indium-111 pentetreotide Covidien OctreoscanTM primary and metastatic neuroendocrine tumors bearing somatostatin receptors

MSDS and package insert information

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