Gastrointestinal malignancies are among the leadingt causes of cancer death. Because of the close correlation between early detection of these tumors and prognosis, they present a special challenge to clinicians. While conventional radiologic methods, including computed tomography, magnet resonance imaging and sonography, are established in the diagnosis and staging of cancers of the gastrointestinal tract, they still suffer from major shortcomings, in so far as small-sized tumors, peritoneal carcinomatosis, or recurrence within postoperative scar tissue might escape detection. Thus, the evaluation of additional methods is warranted. Radioimaging by means of monoclonal antibodies has given promising results in selected cohorts of patients. Despite the high rates of sensitivity in individuals with raising CEA values, but otherwise negative diagnostic workup, the role of antibodies remains to be established, since roughly 30% of lesions are missed in patients with colorectal cancer. While currently available radiolabelled somatostatin analogues do not constitute optimal tracers for imaging of adenocarcinomas, they surpass all conventional imaging modalities in the diagnosis of neuroendocrine tumors. Another neuroendocrine peptide, vasoactive intestinal peptide, has shown promising potential for radioimaging of colorectal, pancreatic and neuroendocrine cancer. In addition, the use of labelled fluoro-deoxy-glucose (FDG) has provided the potential to apply positron emission tomography (PET) in diagnostic oncology. The ability of FDG-PET to preferentially visualize cells with high glucose utilization, i. e. malignant cells, has made PET a highly promising method for radioimaging of malignant lesions. Taken together, newer scintigraphic methods are increasingly becoming able to detect early recurrence or occult metastases, and they offer the possibility to distinguish between viable tumor masses and scar tissue. These advantages over conventional imaging methods make radio-imaging a valuable tool to offer additional information to the clinician involved in the management of cancer patients.

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1998
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