Carcinoma of the stomach - role of gastric imaging for diagnosis and preoperative tumor staging.

The aim of imaging of gastric carcinoma has to be to diagnose the carcinoma as early as possible and to sort out the tumors that are resectable. At th e same time imaging of gastric carcinoma should reduce the number of futile laparotomies in patients with advanced, non-resectable tumors to a minimum . Today, endoscopy is the method of choice to diagnose gastric carcinoma. E ndosonography is advantageous if small carcinomas have to be judged for dep th of tumor infiltration (early gastric carcinoma vs. advanced gastric carc inoma) because high resolution images of the gastric wall are obtained. Sta ging of large carcinomas that have grown beyond the gastric wall is best pe rformed by hydro-CT because CT scans most accurately delineate infiltration s of surrounding organs/structures and help to plan surgery. Nowadays MRI i s not suited for gastric imaging. MRI, however, has the highest potential t o fundamentally improve staging of gastric carcinoma if high resolution ima ging of the gastric wall is combined with screening for metastases in one e xamination.