GASTRIC-CANCER - EVALUATION OF TRIPHASIC SPIRAL CT AND RADIOLOGIC-PATHOLOGICAL CORRELATION

Purpose: The purpose of this study was to evaluate the utility of trip hasic spiral CT with water-filling method in the preoperative T stagin g of gastric cancer. Method: We performed triphasic spiral CT in 108 p atients with gastric cancer (53 with early and 55 with advanced gastri c cancer). The CT findings were prospectively analyzed and correlated with the histopathologic findings, Spiral CT scans were assessed for t he layered pattern of the normal gastric wall, the detectability of tu mor, the enhancing pattern of the tumor, and the depth of tumor invasi on. Results: The layered pattern of the normal gastric wall was clearl y demonstrated in the arterial-dominant or parenchymal phase. All 12 e arly cancers detected with spiral CT were most clearly depicted in the arterial-dominant or parenchymal phase. On the other hand, 15 (28%) o f 54 advanced cancers were most clearly depicted in the equilibrium ph ase due to the gradual enhancement from the inner mucosal side of the tumor. Most of these tumors were scirrhous type tumor containing abund ant fibrous tissue stroma. The accuracy of spiral CT for tumor detecti on and T staging was 98 and 82%, respectively, in advanced gastric can cer and 23 and 15%, respectively, in early gastric cancer. Conclusion: Spiral CT with triphasic scan technique improved the accuracy of esti mating the depth of tumor invasion in advanced gastric cancer.