Helical CT imaging of gastric cancer: normal wall appearance and the potential for staging

To evaluate the CT appearance of the normal gastric wall and the effectiveness of contrast enhanced helical CT for T-staging of gastric cancer.

For the basic experiment, two resected stomachs with gastric cancer were filled with water and examined by helical CT imaging. For the clinical study, 59 consecutive patients with gastric cancer who had received preoperative helical CT examination and had also been operated on were entered in this study. Helical CT images were evaluated independently by three radiologists without knowledge of histological staging results.

The basic examination of a histopathological correlation with CT images revealed that the inner layer with high attenuation corresponded to the mucosa and the muscular layer of the mucosa, the middle layer with low attenuation to the submucosal layer consisting of coarse tissues and containing fatty tissues, and the outer layer with slightly high attenuation to the proper muscle with serosa. The clinical study revealed that the rate of correct diagnosis through consensus reading was 66.1%.

The entire stomach with a well-stained mucosa can be visualized by contrast enhanced helical CT. However, T-staging of gastric cancer by helical CT did not appear to improve the accuracy of staging.