Stomach cancer CT: Difference between revisions
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PET is not an adequate replacement for staging laparoscopy. [67]. | PET is not an adequate replacement for staging laparoscopy. [67]. | ||
[[File:Pet CT gastric cancer.gif|center|300px|PET CT shows gastric cancer, source: Case courtesy of Dr Hani Salam, Radiopaedia.org, rID: 10722]] | |||
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Revision as of 20:29, 16 November 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
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Stomach cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Stomach cancer CT On the Web |
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American Roentgen Ray Society Images of Stomach cancer CT |
Overview
Abdominal CT scan may be helpful in the diagnosis of stomach cancer.
CT
- CT is currently the staging modality of choice because it can help identify the primary tumor.
- It is best suited to evaluating widely metastatic disease, especially hepatic or adnexal metastases, ascites, or distant nodal spread, although biopsy confirmation is recommended because of the risk of false-positive findings.
- Peritoneal metastases and hematogenous metastases smaller than 5 mm are frequently missed by CT in 20 percent of patients [25].
- CT accurately assesses the T stage of the primary tumor in 50 to 70 percent of cases [29-35].
- Sensitivity and specificity rates for regional nodal metastases range from 65 to 97, and 49 to 90 percent, respectively [36-40].
Demonstration of lesions facilitated by negative contrast agents:[1]
- A polypoid mass with or without ulceration
- Focal wall thickening with mucosal irregularity or focal infiltration of wall
- Ulceration: gas-filled ulcer crater within mass
- Infiltrating carcinoma: wall thickening and loss of normal rugal fold pattern
PET scan
integrated PET/CT imaging can be useful to confirm malignant involvement of CT-detected lymphadenopathy [58].
a negative PET is not helpful since even large tumors with a diameter of several centimeters can be falsely negative if the tumor cells have a fairly low metabolic activity. most diffuse type gastric cancers (signet ring carcinomas) are not FDG avid [59-63].
The main benefit of PET is that it is more sensitive than CT for the detection of distant metastases (image 4) [63-66].
PET is not an adequate replacement for staging laparoscopy. [67].
