CT of gastric carcinoma: preliminary results with a new scanning technique

Usefulness of computed tomography (CT) for the demonstration of gastric carcinoma was evaluated in 250 cases with surgical proof of diagnosis: advanced gastric carcinoma (n = 193), early gastric carcinoma (n = 47), gastric submucosal tumor (n = 8), gastric polyp (n = 1), and benign gastric ulcer (n = 1). CT was performed on prone patients after 400-600 mL of water was orally administered and a 100-mL bolus of nonionic contrast material was injected. Water provided optimal distention and satisfactory contrast to depict the normal gastric wall. Prone positioning allowed visualization of the whole gastric wall except for the fundus and prevented artifacts caused by gas during supine imaging. CT demonstrated gastric tumor as a thickened or abnormally enhanced gastric wall in 95% of advanced carcinomas, 93% of elevated early carcinomas, and 18% of depressed early carcinomas. The authors believe that CT performed with this method is useful and that it should be used in addition to barium and endoscopic studies before surgery is planned.