HYDRO-CT IN PATIENTS WITH GASTRIC-CANCER - PREOPERATIVE RADIOLOGIC STAGING

A total of 35 patients (age range 35-78 years) with gastric tumors on the lesser curve, or in the antro-pyloric region, underwent angio-CT i n the prone position after filling the stomach with 500 ml of water an d intravenous administration of glucagon. The films were reviewed by t hree radiologists independently, staging each tumor according to the T NM classification preoperatively. The overall accuracy of tumor stagin g ranged between 66-77%, overstaging between 17-25%, and understaging between 3-8.5%. The diagnostic sensitivity, specificity, and accuracy for serosal invasion ranged between 90 and 100, 76 and 84, and 80-88%, respectively, and the overall accuracy for N staging was 46, 48 and 5 1% for the three observers. If, however, N1 and N2 tumors were conside red as a single group, N-stage accuracy increased, ranging between 63 and 77%. The ''K test'' for analyzing the interobserver agreement was 60%, i.e., the diagnostic results are reproducible. Water filling of t he stomach optimized visualization of the gastric wall on contrast-enh anced CT. The prone position and drug-induced hypotony allows for good distension without any disturbing artifact reduction obscuring the lo wer gastric body.