Spiral CT of the gastric carcinoma: staging and enhancement pattern

The purpose of this study was to correlate the preoperative staging of gastric carcinoma using spiral computed tomography (CT) with pathologic staging and to correlate the enhancement pattern of advanced gastric carcinoma (AGC) on spiral CT with histological type. A total of 180 patients with gastric carcinomas confirmed at surgery underwent spiral CT. After surgery, pathologic findings were compared with CT findings. The detection rate for T1 tumors was 81.4% (57/70), and all T2-4 tumors were detected (110/110). In the T class, good correlation with pathology occurred in 47.8%. In the N class, good correlation with pathology occurred in 52.2%. The rate of understaging in the N class (31.7%) was higher than that of overstaging (16.1%) (P<.001). In AGC, the tumor mass showed delayed enhancement, regardless of Borrmann's type. By histological pattern, good and delayed enhancement was seen in 2/3 (66.7%) with signet ring cell type, but 4/5 (80%) with mucinous type were poorly enhanced (P=.019). Spiral CT for determining the preoperative staging of gastric carcinoma was not accurate. However, the enhancement pattern of AGC correlated with histological type.