Pneumo-esophageal 64-MDCT technique for gastric cancer evaluation
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1 Pneumo-esophageal 64-MDCT technique for gastric cancer evaluation Poster No.: C-1627 Congress: ECR 2010 Type: Scientific Exhibit Topic: GI Tract Authors: M. Ulla, E. Gentile, E. Levy, D. Cavadas, J. Ithurralde Argerich, R. Garcia Monaco; Buenos Aires/AR Keywords: Gastric Cancer, Pneumo-esophageal 64-MDCT, Borman classification DOI: /ecr2010/C-1627 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 28
2 Purpose The usefulness of Pneumo-esophageal 64-MDCT (PN-64CT) technique for characterization of esophageal cancer has been described and published. Our aim is to evaluate the usefulness of this technique for gastric cancer evaluation in correlation with surgical findings. Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Page 2 of 28
3 Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Images for this section: Page 3 of 28
4 Fig. 1 Page 4 of 28
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6 Methods and Materials Between May and September 2009, 10 patients (8 male and 2 female), mean age: 62 years, with gastric cancer diagnosed by biopsy were prospectively studied with PN-64CT before surgery. To achieve gastric distension, a 14F-Foley tube was introduced transorally and settled right below the cricopharyngeal muscles. Continuous CO2 airflow with an automated insufflator was supplied and sustained during the 64-MDCT acquisition. Multiplanar, 3D and virtual endoscopy reconstructions were performed. Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Page 6 of 28
7 Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Page 7 of 28
8 Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Page 8 of 28
9 Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Images for this section: Page 9 of 28
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16 Results Significant distension of the stomach including the gastro-esophageal transition zone was achieved in all patients allowing definition of both upper and lower borders of the tumors. The gastric lumen was visible in all its extension. 10/10 patients studied corresponded to adenocarcinomas. According to Borman classification 1/10 corresponded to type I, 2/10 type II and 2/10 type III and 5/10 type IV. The location of the tumors was: 3/10 major gastric curvature, 2/10 lesser gastric curvature, 2/10 pre-piloric, 1/10 cardias and 2/10 diffuse infiltration. PN-64CT accurately estimated total extent of cancer in all of the patients as well as proximal and distal extent. Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Page 16 of 28
17 Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Page 17 of 28
18 Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Images for this section: Page 18 of 28
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23 Conclusion In this series, optimal distension allowed definition of both upper and lower borders of the tumors, useful for gastric cancer evaluation. It was accurate for the diagnosis and localization of longitudinal extent of gastric cancer. Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Page 23 of 28
24 Fig. References: M. Ulla; Multislice CT Department, Hospital Italiano, Buenos Aires, ARGENTINA Images for this section: Page 24 of 28
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28 References Fishman EK, Urban BA, Hruban RH. CT of the stomach: spectrum of disease. RadioGraphics. 1996; 16: Merino S, Saiz A, Moreno MJ, et al. CT evaluation of gastric wall pathology. Br J Radiol 1999; 72: Moore JR. Gastric carcinoma: 30-year review. Can J Surg 1986; 29: Maruyama M, Baba Y. Diagnosis of the invasive depth of gastric cancer. Abdom Imaging 1994;19: Fukuya T, Honda H, Hayashi T, et al. Lymphnode metastases: efficacy for detection with helical CT in patients with gastric cancer. Radiology 1995; 197: Miettinen M, Lasota J. Gastrointestinal stromal tumors: definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch 2001; 438:1-12. Sharp RM, Ansel HJ, Keel SB. Best cases from the AFIP: gastrointestinal stromal tumor. Radio-Graphics 2001; 21: Buckley JA, Fishman EK. CT evaluation of small bowel neoplasms: spectrum of disease. Radio-Graphics 1998; 18: Personal Information marina.ulla@hospitalitaliano.org.ar Page 28 of 28
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