Abstract:
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Purpose: To correlate high resolution multidetector-row spiral CT with pathologic specimens in staging gastric carcinoma.
Methods and Materials: 40 patients with gastric carcinoma underwent preoperative multislice-CT after drug induced hypotonia and water filling. Precontrast CT was acquired at the level of the upper abdomen with 5 mm slice thickness (2.5mm collimation, 5mm reconstruction interval); after i.v. administration of 150 ml of iodinated contrast media at 4 ml/s, arterial (30 sec delay) and venous (60 sec delay) phases were acquired at 1.25 of slice thickness (1mm collimation; 1mm reconstruction interval). The pelvis was then scanned with 5mm thickness (2.5mm collimation, 5mm reconstruction interval). All images were analyzed with multiplanar reconstructions.
Results: The detection rate of early gastric cancer (ECG) was 71.4% (5/7); the detection rate of advanced gastric cancer (AGC) was 100% (33/33). Regarding the T stage, in 31/40 (77.5%) there was a good correlation with histological results, with a tendency to overstage in 5/40 (12.5%) and to understage in 4/40 (10%). Regarding the N stage a good correlation with pathologic results occurred in 29/40 (72.5%) patients. The rate of understaging was higher 17.5% (7/40) than that of overstaging 10% (4/40). Regarding the M factor CT was concordant with surgical and pathological findings in 39/40 patients (97.5%).
Conclusion: High resolution multidetector-row CT improves tumor detection rate and accuracy of tumor staging as compared to single slice spiral CT results. It may be useful in the preoperative assessment of gastric cancer and has a positive impact in therapeutic decision making.
Marcelli MD, G,
High-resolution Multidetector Row CT in Staging Gastric Cancer. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3107210.html
