Measurement of the Mucosal Surface Distance in the Early Gastric Cancer Using CT Gastrography

Choi, Hyanghee; Chung, Ho Young; Yu, Wansik; Ryeom, Hun Kyu; Lee, Jae Hyuk; Choi, Jae; Kim, Hee Su; Cleary, Kevin; Mun, Seong Ki

Abstract

PURPOSE: Recently, the incidence of early gastric cancer (EGC) patients is rapidly increased in Korea. However, they're often not perceptible by surgical palpation or inspection. The aim of this study is 1) to develope a software that can locate the tumor and measure the mucosal distance from an anatomic landmark to the tumor using CT gastrography and 2) to compare the distance measured by the developed software with the distance measured by the pathologic findings.
MATERIALS AND METHODS
Between January 2004 and September 2005, sixty patients (male=45, female=15, mean 57.8 years old) estimated for EGC with preoperative CT scans and undergone gastrectomies in Kyungpook National University Hospital were enrolled in this study. Preoperative CT scans were performed after insufflations of room air via 5 Fr NG tube. The scans included the following parameters: (slice thickness/reconstruction interval: 0.625 mm, kVp: 120, mAs: 200). 3D volume rendering and measurement of the surface distance from the pylorus to the EGC were performed using the developed software.
RESULTS
The average difference between the lesion to pylorus distances measured from pathologic specimens and CT gastrography was 5.3+/-2.9 mm (range 0~23 mm). The lesion to pylorus distance measured from CT gastrography was well correlated with that measured from the pathologic specimens (r=0.9843, P<0.001).
CONCLUSION
These results suggest that the surface distance from an anatomic landmark to the EGC can be measured accurately by CT gastrography. This technique could be used for preoperative localization of early gastric carcinomas to determine the optimal extent of surgical resection.