Suk Kim MD, Presenter: Nothing to Disclose

Sang Wook Kwak, Abstract Co-Author: Nothing to Disclose

Jun Woo Lee MD, Abstract Co-Author: Nothing to Disclose

Suk Hong Lee, Abstract Co-Author: Nothing to Disclose

Gwang Ha Kim, Abstract Co-Author: Nothing to Disclose

Tae Yong Jeon, Abstract Co-Author: Nothing to Disclose

Do Youn Park, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Since early gastric cancers (EGC) confined mucosa or SM1 layer with its diameter less than 2cm usually don’t metastasize to lymph node, endoscopic mucosal resection can be safely performed as a treatment of EGC. The purpose of this study was to determine the efficacy of MDCT using water filling method in the depiction of early gastric cancer.

One hundred thirteen patients with EGC who underwent MDCT using water filling method and operation were enrolled in the study. Findings at CT including detection rate and CT morphology of lesions were retrospectively reviewed by two radiologists who knew that all of the patients included in this study had EGC. Pathologically, submucosal layer was divided into SM1, SM2, and SM3 on microscopic field. Findings of pathology, including depth of invasion, lesion extent, morphologic type of lesion, location of lesion, and histologic type (intestinal or diffuse) were compared between detectable and undetectable early gastric cancers on MDCT. Statistical analysis was performed with chi-square and independent-sample t test.

Three of one hundred thirteen patients with EGC were excluded because CT was insufficient to enable evaluation of stomach. These patients were excluded from further evaluation. In the remaining 114 EGC in 113 patients, MDCT demonstrated 43 EGC (36.4%); both observers made the correct depiction in 38 of these patients. At comparison of characteristics between the lesion detected and the lesion missed on CT, there were significant differences in depth of invasion (p < 0.05). 15.4% (12/78) superficial lesions (mucosa and SM1 lesions) were detected on CT, whereas 86.1% (31/36) deep lesions (SM2 and SM3 lesions) were detected. There was no significant correlation was found between EGC detection and pathologic findings including lesion extent, location of lesion and histologic type.

Detection rates of EGC on MDCT were significantly determined by the depth of cancer invasion.

Because EGC which was depicted on CT could be highly suggestive of EGC involving SM2 layer or more, the careful attention should be paid for endoscopic mucosal resection of these lesions.

Kim, S, Kwak, S, Lee, J, Lee, S, Kim, G, Jeon, T, Park, D, et al, , Early Gastric Cancer: CT Findings Correlated with Pathology.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4432512.html