Abstract:
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Purpose: To prospectively evaluate the accuracy of hydro-multidetector computed tomography (HMDCT) of the stomach for preoperative staging of gastric cancer in comparison to the post-operative histopathological results.
Methods and Materials: We examined 51 patients with endoscopically detected gastric cancer using a hydro-CT technique combined with multidetector scanning. Twelve patients with T4 underwent palliative surgery with explorative laparatomy. The remaining 39 patients underwent a partial (24) or total gastroectomy (15) with lymphadenectomy. Their CT findings were correlated to histopathological results for T and N staging. Furthermore, distant metastases to the liver and lung were evaluated. The stomach was distended by 1-1.5l flavored methylcellose immediately prior to the examination, and a spasmolytic agent was administered intravenously. The upper abdomen was subjected to multidetector scanning with 4x1mm using an individualized contrast injection protocol based on a test bolus injection. The 3D data set was analyzed using interactive multiplanar reformations. CT findings were analyzed according to a standardized evaluation form and correlated with surgical and histopathological results.
Results: From a total 51 gastric cancers 49 of them were detected in HMDCT with a detectibility rate of 96%. Two early gastric cancers could not be detected. In 41 of 52 cases the assessment of local tumor extension on HMDCT was identical to pathological results in determining the T category according to TNM classification, with overall accuracy of 79 %. The depth of invasion of gastric wall was overstaged at CT in 3 patients and understaged in 8 patients. HMDCT results were in agreement with the histopathology in determining the N category according to TNM classification, in 29 of 39 cases with overall accuracy of 74 %.
Conclusion: Hydro CT in multidetector technique is a very valuable tool in the preoperative staging of gastric cancer
Questions about this event email: ahmed.ba-ssalamah@univie.ac.at
Mehrain MD, S,
Preoperative Staging of Gastric Cancer with Hydro-Multidetector Row CT: Correlation with Surgical and Histopathological Results. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3103395.html
