Review
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 28, 2007; 13(20): 2775-2783
Published online May 28, 2007. doi: 10.3748/wjg.v13.i20.2775
Positron emission tomography/computer tomography: Challenge to conventional imaging modalities in evaluating primary and metastatic liver malignancies
Long Sun, Hua Wu, Yong-Song Guan
Long Sun, Hua Wu, Minnan PET Center, The First Hospital of Xiamen, Fujian Medical University, Xiamen 316003, Fujian Province, China
Yong-Song Guan, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Yong-Song Guan, State Key Laboratory of Biotherapy, West China Medical School, Sichuan University, Gaopeng Street, Keyuan Road 4, Chengdu 610041, Sichuan Province, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Yong-Song Guan, West China Hospital of Sichuan University, Chengdu 610041, China. yongsongguan@yahoo.com
Telephone: +86-28-85421008 Fax: +86-28-85538359
Received: March 21, 2007
Revised: April 10, 2007
Accepted: April 16, 2007
Published online: May 28, 2007
Abstract

Computer tomography (CT) and magnetic resonance imaging (MRI), as conventional imaging modalities, are the preferred methodology for tumor, nodal and systemic metastasis (TNM) staging. However, all the noninvasive techniques in current use are not sufficiently able to identify primary tumors and even unable to define the extent of metastatic spread. In addition, relying exclusively on macromorphological characteristics to make a conclusion runs the risk of misdiagnosis due mainly to the intrinsic limitations of the imaging modalities themselves. Solely based on the macromorphological characteristics of cancer, one cannot give an appropriate assessment of the biological characteristics of tumors. Currently, positron emission tomography/computer tomography (PET/CT) are more and more widely available and their application with 18F-fluorodeoxyglucose (18F-FDG) in oncology has become one of the standard imaging modalities in diagnosing and staging of tumors, and monitoring the therapeutic efficacy in hepatic malignancies. Recently, investigators have measured glucose utilization in liver tumors using 18F-FDG, PET and PET/CT in order to establish diagnosis of tumors, assess their biologic characteristics and predict therapeutic effects on hepatic malignancies. PET/CT with 18F-FDG as a radiotracer may further enhance the hepatic malignancy diagnostic algorithm by accurate diagnosis, staging, restaging and evaluating its biological characteristics, which can benefit the patients suffering from hepatic metastases, hepatocellular carcinoma and cholangiocarcinoma.

Keywords: 18F-fluorodeoxyglucose; Positron emission tomography; Positron emission tomography-computer tomography; Hepatic metastases; Hepatocellular carcinoma; Cholangiocarcinoma