Role of conventional radiology in the diagnosis and staging of gastrointestinal tract neoplasms

Preoperative diagnosis and staging of primary gastrointestinal (GI) neoplas ms are challenges for both clinicians and radiologists. Barium studies are very sensitive in disclosing primary malignancies, even at an early stage. Radiologic signs depend on the evolutional stage of the disease and its app earance on gross pathology. A neoplasm may be manifested on barium studies by a wide spectrum of findings, including mucosal abnormalities, mass prese nce, ulcerative lesions, submucosal infiltration, and lumen stenosis. Advan ced disease can be accurately diagnosed, whereas early cancer should be dif ferentiated from other neoplastic or inflammatory disorders by meticulous a nalysis of radiologic findings. The extent of GI involvement and multiplici ty of the lesions can be assessed on barium studies. In the staging of GI n eoplasms, barium studies are of little value. Skeletal survey by convention al radiographs and chest plain films can reveal distant metastases in a sho rt time and with low cost, although they are not that sensitive to the dete ction of early or subtle lesions. The exact role of conventional radiology in the imaging workup of GI malignancies depends on local expertise and ava ilability of other diagnostic techniques and modalities. (C) 2001 Wiley-Lis s, Inc.