Diagnostic performance of Positron Emission Tomography-Computed Tomography in Assessment of Upper Gastro-Intestinal Tract Oncologic Operative Bed Lesions and Metastatic potentials

Abstract Background: Imaging of the upper gastro-intestinal tract (GIT) operative bed and anastomotic sites is challenging, in the early post operative period there is expected edema and related fat stranding, in the late post operative period there is expected fibrosis limiting adequate distention of the targeted bowel loops. Combined positron emission tomography and computed tomography (PET/CT) is useful addition in the management of oncologic GIT post operative patients with added value in staging, assessment of treatment response, and can alter the management plan according to the situation. Results: 33 patients were included in this study ,27 males (81.8%) and 6 females (18.18%) all with history of upper gastrointestinal tract malignancies managed by surgery with or without adjuvant chemoradiotherapy subjected to positron emission tomography/computed tomography (PET/CT|) follow up. Eighteen patients (54.5%) were presented with positive findings of tumor recurrence or metastatic lesions. And 15 patients (45.45%) were presented with unremarkable operative bed findings. PET/CT results was confirmed by histopathological assessment when accessible and serial follow up. Conclusions: Upper GIT anastomotic sites and operative beds are challenging imaging problem FDG uptake is adding in the confirmation of residual/recurrent neoplastic process and can be useful tool in the management planning.