In cases of suspected small bowel cancer, which imaging tool is most informative?

In cases of suspected small bowel cancer, a CT scan of the abdomen and pelvis is the most informative imaging tool. This is largely due to the CT scan's ability to provide detailed cross-sectional images that can effectively visualize the small intestine and surrounding structures. It allows for assessment of the size and extent of the tumor, evaluation of lymphadenopathy, and identification of potential metastases. Additionally, contrast-enhanced CT scans have improved the diagnostic yield in detecting small bowel lesions compared to other imaging modalities.

Other imaging methods, such as X-rays and ultrasounds, have limitations in the context of small bowel cancer. X-rays may show some alterations in bowel gas patterns but are not definitive for identifying tumors. Ultrasound can help assess certain abdominal conditions, but its ability to visualize the small bowel specifically is often limited due to its gas-filled structures and the overlying bowel. MRI can provide detailed imaging and is useful in specific circumstances, but it generally does not have the same availability and speed as CT, making CT the preferred initial imaging modality for evaluating suspected small bowel cancer.