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Multidetector CT assessment of postgastrectomy patients
Teresa Quarticelli1, Arnaldo Scardapane, Maurizio Memeo
1DiMIMP-Sezione di Diagnostica per Immagini, Ospedale Consorziale Policlinico, Università degli Studi, Bari. terquar@hotmail.com
La Radiologia Medica
|April 23, 2004
Summary
Multidetector CT (MDCT) with advanced reconstructions is a promising tool for detecting gastric cancer recurrence after gastrectomy. While effective for identifying anastomotic, lymph node, and distant metastases, it complements rather than replaces endoscopy.
Area of Science:
- Radiology
- Oncology
- Gastroenterology
Background:
- Gastric carcinoma is a significant cause of cancer mortality worldwide.
- Post-gastrectomy follow-up is crucial for early detection of recurrence.
- Traditional endoscopic methods have limitations in visualizing extraluminal disease.
Purpose of the Study:
- To evaluate the efficacy of multidetector CT (MDCT) with multiplanar reconstructions (MPR) and 3D software.
- To assess MDCT's utility in the postoperative surveillance of patients treated for gastric cancer.
Main Methods:
- 25 patients who underwent gastrectomy for gastric carcinoma were studied.
- Chest-abdominal MDCT with gastric distension and water-soluble contrast was performed.
- Esophago-gastro-duodenoscopy (EGD) and biopsy were used for comparison.
Main Results:
- MDCT detected recurrence in 9 out of 25 patients, including liver metastases and lymphadenopathy.
- MPR enhanced visualization of lesion extension, and 3D reconstructions aided anastomotic loop assessment.
- EGD confirmed recurrence in 9 patients and identified gastritis in one.
Conclusions:
- MDCT with MPR and 3D reconstructions shows promise for postoperative gastric cancer follow-up.
- This imaging modality is valuable for detecting anastomotic, nodal, and distant recurrences.
- MDCT serves as a useful adjunct to endoscopy in patient surveillance.