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The role of three-dimensional multidetector CT gastrography in the preoperative imaging of stomach cancer: emphasis on detection and localization of the tumor.

Kim JW, Shin SS, Heo SH, Lim HS, Lim NY, Park YK, Jeong YY, Kang HK - Korean J Radiol (2015)

Bottom Line: It has the ability to produce various three-dimensional (3D) images.Because 3D reconstruction images are more effective and intuitive for recognizing abnormal changes in the gastric folds and subtle mucosal nodularity than two-dimensional images, 3D MDCT gastrography can enhance the detection rate of early gastric cancer, which, in turn, contributes to the improvement of the accuracy of preoperative tumor (T) staging.In addition, shaded surface display and tissue transition projection images provide a global view of the stomach, with the exact location of gastric cancer, which may replace the need for barium studies.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Chonnam National University Medical School, Gwangju 501-757, Korea.

ABSTRACT
Multidetector CT (MDCT) gastrography has been regarded as a promising technique for the preoperative imaging of gastric cancer. It has the ability to produce various three-dimensional (3D) images. Because 3D reconstruction images are more effective and intuitive for recognizing abnormal changes in the gastric folds and subtle mucosal nodularity than two-dimensional images, 3D MDCT gastrography can enhance the detection rate of early gastric cancer, which, in turn, contributes to the improvement of the accuracy of preoperative tumor (T) staging. In addition, shaded surface display and tissue transition projection images provide a global view of the stomach, with the exact location of gastric cancer, which may replace the need for barium studies. In this article, we discuss technical factors in producing high-quality MDCT gastrographic images and present cases demonstrating the usefulness of MDCT gastrography for the detection and T staging of gastric cancer while emphasizing the significance of preoperative localization of gastric cancer in terms of surgical margin.

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Related in: MedlinePlus

Case of early gastric cancer (EGC) (type IIa) in which re-operation was performed because location of EGC was incorrectly determined by conventional endoscopy, in contrast to CT gastrography.A. EGC (arrows) was determined to be at lesser curvature of gastric mid-body using conventional endoscopy. Laparoscopic distal gastrectomy was planned based on conventional endoscopic findings. B, C. In contrast to conventional endoscopic findings, EGC (arrow) is depicted at upper body on both virtual endoscopy (B) and tissue transition projection (C) images. However, planned laparoscopic distal gastrectomy was finally performed according to location of EGC using conventional endoscopy. With surgical specimen, EGC was confirmed to be located at upper body. Re-operation (near-total gastrectomy) was subsequently performed due to insufficient proximal resected margin after initial laparoscopic distal gastrectomy.
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Figure 4: Case of early gastric cancer (EGC) (type IIa) in which re-operation was performed because location of EGC was incorrectly determined by conventional endoscopy, in contrast to CT gastrography.A. EGC (arrows) was determined to be at lesser curvature of gastric mid-body using conventional endoscopy. Laparoscopic distal gastrectomy was planned based on conventional endoscopic findings. B, C. In contrast to conventional endoscopic findings, EGC (arrow) is depicted at upper body on both virtual endoscopy (B) and tissue transition projection (C) images. However, planned laparoscopic distal gastrectomy was finally performed according to location of EGC using conventional endoscopy. With surgical specimen, EGC was confirmed to be located at upper body. Re-operation (near-total gastrectomy) was subsequently performed due to insufficient proximal resected margin after initial laparoscopic distal gastrectomy.

Mentions: In contrast, it is possible to find the location of the gastric cancer more accurately before treatment using various 3D reconstruction images, such as VE, TTP, and SSD images, even if the location of gastric cancer was previously determined incorrectly using conventional endoscopy (Fig. 4) (19). Thus, 3D CTG images can help clinicians decide on the optimal treatment options by providing reliable information in regard to the location of the tumor (3, 20).


The role of three-dimensional multidetector CT gastrography in the preoperative imaging of stomach cancer: emphasis on detection and localization of the tumor.

Kim JW, Shin SS, Heo SH, Lim HS, Lim NY, Park YK, Jeong YY, Kang HK - Korean J Radiol (2015)

Case of early gastric cancer (EGC) (type IIa) in which re-operation was performed because location of EGC was incorrectly determined by conventional endoscopy, in contrast to CT gastrography.A. EGC (arrows) was determined to be at lesser curvature of gastric mid-body using conventional endoscopy. Laparoscopic distal gastrectomy was planned based on conventional endoscopic findings. B, C. In contrast to conventional endoscopic findings, EGC (arrow) is depicted at upper body on both virtual endoscopy (B) and tissue transition projection (C) images. However, planned laparoscopic distal gastrectomy was finally performed according to location of EGC using conventional endoscopy. With surgical specimen, EGC was confirmed to be located at upper body. Re-operation (near-total gastrectomy) was subsequently performed due to insufficient proximal resected margin after initial laparoscopic distal gastrectomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296280&req=5

Figure 4: Case of early gastric cancer (EGC) (type IIa) in which re-operation was performed because location of EGC was incorrectly determined by conventional endoscopy, in contrast to CT gastrography.A. EGC (arrows) was determined to be at lesser curvature of gastric mid-body using conventional endoscopy. Laparoscopic distal gastrectomy was planned based on conventional endoscopic findings. B, C. In contrast to conventional endoscopic findings, EGC (arrow) is depicted at upper body on both virtual endoscopy (B) and tissue transition projection (C) images. However, planned laparoscopic distal gastrectomy was finally performed according to location of EGC using conventional endoscopy. With surgical specimen, EGC was confirmed to be located at upper body. Re-operation (near-total gastrectomy) was subsequently performed due to insufficient proximal resected margin after initial laparoscopic distal gastrectomy.
Mentions: In contrast, it is possible to find the location of the gastric cancer more accurately before treatment using various 3D reconstruction images, such as VE, TTP, and SSD images, even if the location of gastric cancer was previously determined incorrectly using conventional endoscopy (Fig. 4) (19). Thus, 3D CTG images can help clinicians decide on the optimal treatment options by providing reliable information in regard to the location of the tumor (3, 20).

Bottom Line: It has the ability to produce various three-dimensional (3D) images.Because 3D reconstruction images are more effective and intuitive for recognizing abnormal changes in the gastric folds and subtle mucosal nodularity than two-dimensional images, 3D MDCT gastrography can enhance the detection rate of early gastric cancer, which, in turn, contributes to the improvement of the accuracy of preoperative tumor (T) staging.In addition, shaded surface display and tissue transition projection images provide a global view of the stomach, with the exact location of gastric cancer, which may replace the need for barium studies.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Chonnam National University Medical School, Gwangju 501-757, Korea.

ABSTRACT
Multidetector CT (MDCT) gastrography has been regarded as a promising technique for the preoperative imaging of gastric cancer. It has the ability to produce various three-dimensional (3D) images. Because 3D reconstruction images are more effective and intuitive for recognizing abnormal changes in the gastric folds and subtle mucosal nodularity than two-dimensional images, 3D MDCT gastrography can enhance the detection rate of early gastric cancer, which, in turn, contributes to the improvement of the accuracy of preoperative tumor (T) staging. In addition, shaded surface display and tissue transition projection images provide a global view of the stomach, with the exact location of gastric cancer, which may replace the need for barium studies. In this article, we discuss technical factors in producing high-quality MDCT gastrographic images and present cases demonstrating the usefulness of MDCT gastrography for the detection and T staging of gastric cancer while emphasizing the significance of preoperative localization of gastric cancer in terms of surgical margin.

Show MeSH
Related in: MedlinePlus