Radiologic staging of gastrointestinal cancer

Pre-operative staging should define the probable course of a patient's disease, separate the resectable from the unresectable patients, and identify the patients who are candidates for induction therapy. Pre-operative staging must be well tolerated and should provide new or important information that will affect the proposed treatment plan. For some diseases such as colon cancer, pre-operative staging is largely unnecessary, but it can be of great value for other tumors such as pancreatic cancer. Currently, many imaging techniques are available to evaluate gastrointestinal cancers, and each provides information necessary for directing treatment. Although no individual technique can stage patients with complete accuracy, combinations of the various imaging techniques can be used to increase accuracy and promote appropriate decisions about an individual's treatment options. The use of current imaging techniques for staging primary lesions, regional spread, and the intra-abdominal metastatic spread of the most common gastrointestinal malignancies are reviewed.