Two-dimensional and three-dimensional imaging of gastric tumors using spiral CT

Recent advances in computed tomographic (CT) technology, three-dimensional imaging software, and cheaper data storage capacity have made faster, simpler, and more accurate gastric imaging available. Two-dimensional multiplanar reformation and CT gastrography including virtual gastroscopy and transparency rendering allow multiplanar cross-sectional imaging, gastroscopic viewing, and upper gastrointestinal series imaging in the same data acquisition. Multi-detector row CT allows noninvasive assessment of the gastric wall and the perigastric extent of disease. It is also helpful in detection and evaluation of gastric malignancies and a variety of inflammatory conditions that affect the stomach. Conventional gastroscopy provides the most useful information about the exact location of the lesion and also allows performance of biopsy. Endoscopic ultrasonography (US) provides the most useful information about horizontal extension of the tumor, the depth of mural invasion, and perigastric lymphadenopathy. However, endoscopic US has not been able to replace CT for tumor staging because of its limitations in demonstrating distant lymphadenopathy or metastatic deposits.

Section: Introductionmentioning

confidence: 99%

Imaging of Various Gastric Lesions with 2D MPR and CT Gastrography Performed with Multidetector CT

Kim

Eun²,

Goo³

et al. 2006

“…It is also important to recognize the surgically reconstructed areas after a Whipple procedure and gastric bypass surgery because the frequently un-opacified afferent loops may simulate tumor recurrence. Doubts regarding bowel loops are best resolved with administration of additional positive oral contrast material, a change in patient posture, or off-axial MPR and VR images (22,23).…”

Section: Potential Pitfalls Stomach Duodenum and Proximal Jejunummentioning

confidence: 99%

Peripancreatic Masses That Simulate Pancreatic Disease: Spectrum of Disease and Role of CT

Lawler¹,

Horton²,

Fishman³

2003

A number of entities can simulate pancreatic disease at computed tomography (CT), which may lead to misdiagnosis. Common pitfalls include peripancreatic lesions of the foregut, adrenal gland, and kidney as well as disease of the mesentery and neurovascular structures. Optimal design and application of multi-detector row CT protocols with multiplanar reformation and maximum-intensity-projection and volume-rendering postprocessing improves the specificity of image interpretation. In most cases, helical CT is highly accurate for distinguishing primary disease of the pancreas from adjacent disease, although there are cases in which the differential diagnosis is more challenging and the potential for misdiagnosis still exists. Familiarity with some of the entities that can simulate pancreatic disease, careful attention to scanning protocol and contrast material administration, use of the full potential of multi-detector row CT data sets, and judicious application of postprocessing tools may help avoid some of the pitfalls caused by peripancreatic lesions.

“…Recent advances in CT technology, including the introduction of multidetector CT and the development of three-dimensional (3D) imaging systems, may potentially improve the evaluation of various gastric diseases (13)(14)(15)(16)(17)(18)(19)(20). Multidetector CT involves isotropic imaging of the stomach and allows high-quality multiplanar reformation (MPR) and endoluminal 3D virtual endoscopy in this setting.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Early Gastric Cancer at Multidetector CT with Multiplanar Reformation and Virtual Endoscopy

Shen

Kang²,

Jeong³

et al. 2011

Early gastric cancer (EGC) is defined as a carcinoma in which invasion is limited to the mucosa and submucosa, regardless of lymph node status and distant metastasis. Recent advances in multidetector computed tomography (CT) with multiplanar reformation (MPR) provide a powerful tool for identifying gastric wall invasion and the perigastric extent of gastric cancer. In addition, MPR images confer advantages in the assessment of both intra- and extraluminal processes of the gastric wall and the evaluation of more distant regions, such as the paraaortic lymph nodes and other abdominal organs. Virtual endoscopy performed after air distention of the stomach can aid in the evaluation of gastric endoluminal morphologic features and the extent of EGC. Moreover, virtual endoscopy helps in detecting subtle mucosal changes and differentiating them from submucosal lesions in the same way as conventional endoscopy. Virtual endoscopy can depict abnormal endoluminal lesions within a wider field of view than can conventional endoscopy, and there are no "blind spots" because retrospective image reformation is available, which provides useful information for preoperative mapping. Multidetector CT with MPR and virtual endoscopy is a powerful, noninvasive tool for the early detection and accurate preoperative staging of EGC.