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Fluoroscopic-guided in vivo gastric mapping for assessment of gastric carcinoma
R S Makuch1, G N Bender, M D Brissette
1Department of Radiology, Madigan Army Medical Center, Tacoma, Washington 98431, USA.
Rationale And Objectives:
The authors seek to determine if a new method of combining fluoroscopy and nasogastric biopsy can demonstrate the existence and boundary limits of a known gastric carcinoma or its premalignant conditions. The study is performed in hopes of avoiding unnecessary surgery or limiting resection.
Methods:
Two cases are presented to illustrate the technique. The first had a known gastric carcinoma; the other had adenomatous change in the antrum. After topical anesthesia was applied, a nasogastric tube with a coaxial biopsy forceps was inserted. Multiple biopsies were taken in a designed geographic pattern and sent to pathology. The patient with known carcinoma received a total gastrectomy. The specimen was sectioned in the same regions as the biopsies to validate mapping technique.
Results:
Pathology results for sectioned stomach were nearly identical to the biopsies showing the technique can accurately map the stomach. No adenomatous change in the antrum or other sections of the stomach was observed in the second case. This resulted in the patient being spared gastric resection.
Conclusions:
Fluoroscopic-guided gastric mapping can aid in determining the boundaries of a known carcinoma or premalignant conditions. Additional cases and follow-up are necessary.