Ahmed Ba-Ssalamah MD, Abstract Co-Author: Nothing to Disclose

Katja Pinker MD, Presenter: Research funded, Bracco Group

Wolfgang K. Matzek MD, Abstract Co-Author: Nothing to Disclose

Johannes Zacherl MD, Abstract Co-Author: Nothing to Disclose

Christian Johannes Herold MD, Abstract Co-Author: Nothing to Disclose

Wolfgang Schima MD, Abstract Co-Author: Nothing to Disclose

To compare the diagnostic efficacy of Hydro-multidetector computed tomography (HMDCT) in the preoperative staging of gastric cancer with the endoscopic ultrasound (EUS) using the post-operative histopathological results as gold standard.

Between 01/2001 and 04/2006 156 patients with gastric cancer, previously diagnosed by biopsy prior to surgery on two different days, were enrolled in this study. All patients underwent both HMDCT and EUS examinations. HMDCT scans were performed using 4 channel-, 16 channel- or 64 channel scanners. EUS were performed using a fiber-optic endoscopy with a 5-10 MHz electronic array with a 360° scanning angle. Scanning protocol included intravenous application of 140ml of standard contrast agent using care bolus technique. Distention of the stomach was achieved by oral application of 1 to 1.5L of water. In patients with heart-failure a suspension of methylcellulose was orally administered. The HMDCT and EUS findings were prospectively analyzed by two experienced radiologist in consensus: each case was staged according to the TNM classification and correlated with histopathological findings. Accuracy of TNM-staging was calculated for each modality, findings of both EUS and HMDCT were directly compared to each other and then correlated with histopathological findings.

From a total of 156 tumors HMDCT detected 153 with a sensitivity of 98% whereas sensitivity of EUS was 100%. The three small tumors missed by HMDCT were T1-stage lesions. The accuracy for T staging with HMDCT was 89%, for N staging 78% and for M staging 97%. The results of EUS were 79%, 61%, and 43% respectively.

HMDCT is almost equal to EUS in lesion detection and more accurate in TNM-staging of gastric cancer in comparison to EUS. HMDCT demonstrated superior diagnostic efficacy in the preoperative assessment of advanced gastric cancer and influenced preoperative patient management as well as surgical therapy.

Due to the higher accuracy in TNM-staging of gastric cancer HMDCT is able to replace EUS in preoperative evaluation.

Ba-Ssalamah, A, Pinker, K, Matzek, W, Zacherl, J, Herold, C, Schima, W, Can the Non-invasive Hydro-Multidetector-row CT Replace the Endoscopic Ultrasound in the Preoperative Staging of Gastric Cancer?.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4437041.html