Stomach cancer other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2] Mohammed Abdelwahed M.D[3]

Overview

Barium studies may be diagnostic of stomach cancer. The sensitivity of barium meals may be 14%. False-negative barium studies can occur in 50 percent of cases. There are three types of early gastric cancer which include polypoid, ulcerated, and superficial.

Barium studies

• Barium studies (double contrast barium) can identify both malignant gastric ulcers and infiltrating lesions.
• False-negative barium studies can occur in 50 percent of cases.
• For early gastric cancer, the sensitivity of barium meals may be 14%.
• Early gastric cancer has three types:
  • Type I: Elevated lesion, protrudes >5 mm into lumen (polypoid).
  • Type II: superficial lesion (plaque-like, mucosal nodularity, ulceration).
  • Type III: Shallow, irregular ulcer crater with adjacent nodular mucosa and clubbing/fusion/amputation of radiation folds.

• Advanced gastric cancer may further be of the following types:
  • Polypoid cancer can be lobulated or fungating.
  • Lesion on anterior wall: A thin layer of barium trapped between edge of mass & adjacent mucosa.
  • Ulcerated carcinoma: 70% of all gastric cancers.

Double contrast images from a barium meal study showing an advanced gastric malignancy involving the body of stomach, source: Case courtesy of Dr Ian Bickle, Radiopaedia.org, rID: 21214