Journal of the Formosan Medical Association
Volume 106, Issue 11 , Pages 943-952, November 2007

Preoperative Diagnosis of Gastric Tumors by Three-dimensional Multidetector Row CT and Double Contrast Barium Meal Study: Correlation with Surgical and Histologic Results

  • Bang-Bin Chen

      Affiliations

    • Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Po-Chin Liang

      Affiliations

    • Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Kao-Lang Liu

      Affiliations

    • Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Jong-Kai Hsiao

      Affiliations

    • Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Jun-Chieh Huang

      Affiliations

    • Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Jau-Min Wong

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Po-Huang Lee

      Affiliations

    • Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Chia-Tung Shun

      Affiliations

    • Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Yuk Ming-Tsang

      Affiliations

    • Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Yuk Ming-Tsang, Department of Medical Imaging, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 22 January 2007; received in revised form 27 March 2007; accepted 7 August 2007.

Background/Purpose

Recent three-dimensional multidetector row computed tomography (3D MDCT) can provide detailed images of a gastric tumor, including its general contour, location and depth. We therefore evaluated the efficacy of MDCT in the differential diagnosis and staging of gastric tumors in patients prepared for surgery.

Methods

Seventy-nine patients with gastric tumors identified by gastric optical endoscopy were admitted for preoperative evaluation. All patients received double-contrast barium meal (DCBM) study and abdominal MDCT with 3D reconstruction before surgery. We compared the accuracy of MDCT with DCBM study in detecting and differentiating gastric tumors. In addition, the MDCT findings were correlated with surgical and pathologic results in gastric cancers for Borrmann type, T and N stages.

Results

Among the 79 patients with gastric tumors, there were 24 cases of early gastric cancer, 40 cases of advanced gastric cancer, 12 cases of gastrointestinal stromal tumor, and three cases of gastric lymphoma. Both MDCT and DCBM were very accurate in picking up the lesions (100%). The diagnostic accuracies of MDCT and DCBM were similar (94% vs. 96%) in differentiating mucosal and submucosal lesions as well as classification of Borrmann type in advanced gastric cancer (70% vs. 63%). In 64 patients with gastric cancers, there was good correlation between MDCT images and pathology in 73% of T staging and 69% of N staging.

Conclusion

MDCT has a similar high accuracy in the preoperative diagnosis of different gastric tumors compared with DCBM and provides additional information including tumor depth, lymph node and hepatic metastasis. Therefore, MDCT may be used as a primary tool for preoperative tumor diagnosis and staging.

Key Words:  barium sulfate , computed tomography , diagnostic use , neoplasms , stomach

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PII: S0929-6646(08)60065-0

doi:10.1016/S0929-6646(08)60065-0

Journal of the Formosan Medical Association
Volume 106, Issue 11 , Pages 943-952, November 2007

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