Marco Di Girolamo MD, Presenter: Nothing to Disclose

Paola Mancini, Abstract Co-Author: Nothing to Disclose

Ludovica Argnani, Abstract Co-Author: Nothing to Disclose

Alberto D Amato, Abstract Co-Author: Nothing to Disclose

Paolo Aurello, Abstract Co-Author: Nothing to Disclose

Vincenzo David, Abstract Co-Author: Nothing to Disclose

To evaluate the accuracy of hydro-MSCT in the pre-surgical evaluation of gastric adenocarcinoma and to make a comparison with the results of surgery and histopathology.

70 patients with gastric adenocarcinoma, diagnosed with endoscopy and biopsy, underwent hydro-multislice CT (hydro-MSCT) using a 16 detectors device (Philips Mx8000 IDT). In 2 other patients gastric adenocarcinoma was detected only with hydro-MSCT because the preliminary gastric biopsy was negative. The distension of the gastric lumen was obtained through the oral administration of 4 gut of water and the i.v. injection of 20 mg Buscopan. The patients were always placed in the supine position also in case of neoplasm located at the level of antrum. Abdominal MSCT was performed using these parameters: collimation:16x0,75 mm;table speed:17,6mm/s;pitch:1,1;sl.thick.:1 mm. 100 ml of non-ionic contrast media was i.v. administered with 3 ml/s flow rate. The contrast-enhanced dynamic study was performed during arterial and portal phase. The 3D data set was analysed using MPR.

Hydro-MSCT always allowed the detection of gastric cancer and the portal phase had the best detection rate. The tumor was pre-operative classified as T1 stage in 20 cases, T2 in 30, T3 in 14 and as T4 stage in 8. In 58 patients the assessment of local tumor extension on hydro-MSCT was identical to histopathological results in defining the T category according TNM classification, with overall accuracy of 80%. We found an overstaging in 10 cases of T1 or T2 stage cancer classified as T3 with hydro-MSCT and an understaging in 4 cases of T2 stage cancer classified as T1. The desmoplastic reaction was differentiated by neoplastic infiltration in 90% of cases. The peri-gastric, mesenteric and celiac enlarged lymph node were always identified but MSCT did not allow to differentiate neoplastic from reactive lymph node and the CT results were in agreement with histo-pathological results in 60% of cases. In 3 patients hydro-MSCT diagnosed peritoneal carcinosis allowing detection of thin peritoneal implants.

Hydro-MSCT using a 16 detectors device is a feasible proposal in the detection and pre-operative staging of gastric adenocarcinoma.

Di Girolamo, M, Mancini, P, Argnani, L, D Amato, A, Aurello, P, David, V, Hydro-Multislice CT in the Study of Gastric Adenocarcinoma: A Comparative Study with Surgical and Histopathological Results.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4407012.html