The current role of PET-CT in the characterization of hepatobiliary malignancies.
BACKGROUND
Surgery has become heavily dependent on accurate imaging in the assessment and treatment of suspected or confirmed intra-abdominal malignancy. Positron emission tomography-computed tomography (PET-CT) fuses uptake of a radiotracer combined with CT images to assess both functional tissue activity and anatomical detail. Since its introduction it has offered new ways of treating gastrointestinal cancers.


METHODS
The review analyses the present literature regarding the use of PET-CT in the assessment, diagnosis, staging and treatment of hepatobiliary malignancies.


RESULTS
PET-CT is widely used in pre-operative tumours staging for colorectal liver metastases. There is convincing data that it may also be applicable for neuroendocrine tumours, assessment of indeterminate pancreas lesions and clinical drug trials. PET-CT is of limited value in hepatocellular cancers, although new techniques in dual-tracer PET-CT may change this.


CONCLUSIONS
Knowledge of the strengths and limitations of PET-CT is important for all surgeons managing cancer of the hepatobiliary system. More clinical data are required on PET-CT, particularly its effect on long-term survival in PET-CT-staged patients undergoing resection.
Garcea
Ginseppe
G
Department of Hepatobiliary and Upper Gastrointestinal Surgery, The Queen Elizabeth Hospital, Adelaide, SA, Australia. gg43@le.ac.uk
Ong
Seok Ling
SL
Maddern
Guy J
GJ