Abstract:
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Purpose: To evaluated the diagnostic value of CT gastroscopy using multidetector-row CT(MDCT) for detection and characterization of gastric cancer in patients who were suspected to have gastric cancer.
Methods and Materials: CT gastroscopy examinations using MDCT was performed in consecutive 162 patients who suspected to have gastic cancer. Unenhanced and contrast-enhanced CT scans were obtained on a MDCT scanner (LightSpeed QX/I, GE Medical System, Milwaukee, Wis. USA) with a HQ mode after injection of anti-peristaltic agent and gaseous distention of the stomach. Scanning parameters were as follows: detector collimation, 1.25 mm; table feed 3.75 mm; reconstruction interval, 0.625 mm. Unenhanced images were obtained in prone position and contrast-enhanced images in supine position. After scanning, CT gastroscopy was processed on a workstation using software (Advantage Workstation, GE Medical Systems) by one experienced radiologist who was blind to the clinical information. Gastric cancer was confirmed in 150 patients. We analyzed the detection and gross morphologic features of the lesion on CT gastroscopic images, and then we compared the results with pathologic findings in 123 patients who had surgical operation (56 early gastric cancer, 67 advanced gastric cancer).
Results: CT gastroscopy depicted gastric cancers in 112 of 123 cases (91%). Of 67 cases with advanced gastric cancer (AGC), 65 cases were detected with CT gastroscopy (97%). Regarding early gastric cancer (EGC), the detection rate of CT gastroscopy was slightly low (84%). In characterization of morphologic features, 61 cases (94%) of AGC and 34 cases (72%) of EGC were correct. Among the 56 cases of EGC, 12 cases were misdiagnosed to AGC and the most frequent fault was overestimation of EGC type IIc+IIb or IIb+IIc or Iic+Iia to AGC Borrmann type III (11 cases). EGCs located in gastric angle and antrum were frequently overestimated to AGC (11/12). Seven cases out of 9 missed EGCs had type IIb lesions mainly or patially.
Conclusion: In most patients suspected to have gastric cancer, CT gastroscopy showed excellent results in detection and characterization of gastric cancer, especially in advanced gastric cancer. However, in the detection and characterization of EGC, it had limited value.
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Ko MD, E,
Performance of CT Gastroscopy Using Multidetector Row CT in Evaluating Gastric Cancer. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3108809.html
