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KMID : 0616620010070010155
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Journal of Soonchunhyang Medical College
2001 Volume.7 No. 1 p.155 ~ p.166
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Usefulness of Two-Phase Spiral CT in Staging of Gastric Carcinoma
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Choi Gyo-Chang
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Abstract
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Purpose: to evaluate the usefulness of two-phase spiral CT in the staging of gastric carcinoma.
Materials and Methods: The author performed two-phase spiral CT in 49 patients with gastric carcinomas surgically and pathologically proven after endoscopic biopsy. CT scans were obtained after ingestion of 800-1000mL of water. In all 49 patients, two-phase spiral CT findings of gastric carcinoma were retrospectively evaluated and correlated with surgical and pathological findings.
Results: The author correctly detected 15(83.3%) of 18 early carcinoma and 31(100%) of 31 advanced gastric carcinomas by two-phase spiral CT. The overall detection rate of gastric carcinomas was 93.9%(46 of 49 cases). The detection rate of early gastric carcinoma was 100(5 of 5 cases) among elevated lesions and 76.9%(10 of 13 cases) among flat or depressed lesions. With regard to the depth of tumor invasion, there was good correlation between CT findings and pathologic findings in 28 of 49 cases(57.1%). Overstaging occurred in 24.5%(12 of 49 cases) and understaging in 18.4%(9 of 49 cases). In lymph node staging, good correlation between CT findings and pathologic findings was noted in 33 of 49 cases(67.3%). Understaging occurred in 18.4%(9 of 49 cases) and overstaging in 14.3%(7 of 49 cases). All of liver metastases(3 cases) and peritoneal carcinomatosis(1 case) were correctly diagnosed by two-phase spiral CT.
Conclusion: In the staging of gastric carcinoma, two-phase spiral CT is useful in the detection of early gastric carcinoma and distant metastasis. However, for determining the depth of tumor invasion and for the evaluation of metastasis of lymph node its usefulness in limited. Further research using various analytic approaches will therefore be necessary.
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KEYWORD
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Stomach, CT, neoplasm, Computed tomography(CT), helical
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