Two-phase dynamic contrast-enhanced computed tomography with water-fillingmethod for staging of gastric carcinoma

The objective of the study was to evaluate the usefulness of two-phase incr emental contrast-enhanced computed tomography (CT) with water-filling metho d in the preoperative assessment of stomach carcinoma. Dynamic CT was done in 20 patients with biopsy-proven gastric cancers and the findings were com pared with surgery. A 150-ml ionic contrast medium was administered intrave nously at a flow rate of 3.5 ml/s. CT scanning was done at 45 s (early phas e) and 3 min (equilibrium phase) after the start of intravenous injection. Primary tumors were detected in all the cases. The overall accuracies of dy namic CT in determining depth of tumor invasion, pancreatic invasion, adjac ent liver infiltration, and lymph node metastasis were 85% (17/20), 90% (18 /20), 85% (17/20), and 69% (13/19), respectively. The early phase of dynami c CT is highly accurate in determining the depth of tumor invasion of advan ced gastric cancers but has low sensitivity in the detection of nodal metas tasis. The delayed phase scans do not add any additional information and he nce, should not be routinely used for staging. (C) 2001 Elsevier Science In c. All rights reserved.