Comparative Study of Transabdominal Ultrasonography and Multidetector Row Computed Tomography in Preoperative Staging of Gastric Carcinoma

Abstract

Gastric cancer is one of the most common malignant tumours in the digestive tract and is the second most common cause of cancer-related death worldwide. The incidence in India is 7-8 cases per 100,000 persons per year and it is the most common cancer in males in Chennai. The aim of the present study was to compare Ultrasonography (USG) and MDCT findings in the detection and staging of gastric carcinoma by correlating with histopathology. Material and methods: Data were collected from 30 cases of clinically suspected/proven cases of gastric carcinoma that were referred to the Department of Radiodiagnosis for Ultrasonography and MDCT. Ultrasound examination was performed using a real time ultrasound with curvilinear transducer of 2-5 MHz and linear transducer of 7-10 MHz with ingestion of boiled cooled water. Plain and contrast MDCT study was performed in all the cases. The comparative study of ultrasonography and MDCT in diagnosing and staging of gastric carcinoma were analysed. Results: The accuracy in detection of gastric carcinoma by USG was 80% (24/30 cases) and MDCT was 87% (26/30 cases), with p value of < 0.01 which is significant, which shows CT is better modality for diagnosing gastric carcinoma. For T staging, the efficacy of MDCT and USG was 90% (27/30 cases) and 80% (24/30 cases) respectively. For nodal status, the accuracy of CT is 73.3 %(22/30 cases) and USG is 63.3 %(19/30 cases). For distant metastasis, accuracy was same with USG and CT (70%, 27/30 cases). But when both the modalities are combined, the efficacy improves for diagnosing and staging gastric carcinoma by 93% with P<0.05. The anastomosis degree of the gastric carcinoma between enhanced CT and ultrasonography was κ=0.404 Conclusion: Overall USG and Multi-detector row CT with combined water and air distention can improve the accuracy of preoperative staging of gastric cancer. Comprehensive imaging of US and MDCT is helpful to improve the accuracy of detection and staging of gastric carcinoma.