• Journal of Gastric Cancer
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• v.6 no.4
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• pp.207-213
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• 2006

Purpose: This study was performed to evaluate the usefulness of computed tomography (CT) gastrography in the surgical management of a gastric gastrointestinal stromal tumor (GIST). Materials and Methods: We retrospectively analyzed the clinicopathologic data of 38 patients who had undergone CT gastrography from among patients who had gastric GISTS surgically resected at the Department of Surgery, Seoul National University Hospital, between January 2001 and February 2006. We compared CT gastrography data, including tumor size and location and distance from the gastroesophageal junction or pylorus with endoscopic, surgical and pathologic findings. Results: The longitudinal tumor locations on CT gastrography and endoscopy were identical to the surgical findings. For tumor sizes on CT gastrography of less than 5 cm, we performed 11 (42.3%) laparoscopic wedge resections from among 26 cases. In the 12 cases with tumor sizes of 5 cm or over, only 1 (8.3%) laparoscopic wedge resection was performed. When the tumor was located in the middle third of the stomach, a laparoscopic wedge resection was performed in 88.9% (8/9) of the cases, but when it was located in the upper or lower third, a laparoscopic wedge resection was performed in only 13.8% (4/29) of the cases. Conclusion: Three-dimensional information from CT gastrography allows the surgeon to perform preoperative planning, including accurate localization.

• Journal of Gastric Cancer
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• v.3 no.4
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• pp.195-200
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• 2003

Purpose: Advancement of computed tomography (CT) hardware and software has allowed thin section scanning and reconstruction of fascinating 2-dimentional (2D) and 3- dimentional (3D) images. Especially, the reconstruction of 3D images of gastrointestinal tract has been used in the detection and diagnosis of pre-malignant and malignant diseases. To compare the efficacy of CT gastrography with conventional upper gastrointenstinal series (UGIs) in gastric cancer patients. Materials and Methods: During Nov. 2002 and Mar. 2003, twenty-seven patients who had gastric cancer received both double contrast upper GI series and CT gastrography prior to radical surgery. Among these patients, nineteen had early gastric cancer (EGC) and 8 had advanced gastric cancer (AGC). Fifteen patients were male and 12 were female. The mean age was 54 yrs (range, $27\∼75$ yrs). The patients were placed on NPO and Stomach was distended with gas in fasting state prior to CT scanning. Double contrast upper GI series were performed as routine manual. CT scan was conducted in all patients using 8 or 16-channel multidetector CT in this study. The collimation and reconstruction for CT scanning were set at 2.5 mm and 1.25 mm, respectively. CT scanning was performed in the supine position. For image processing, CT gastrography, in which raysum and surface rendering images were constructed, virtual and 2D image in coronal and sagittal images were performed. The detectability of gastric cancer was assessed between UGIs and CT gastrography. Results: In AGCs, the detection rate of cancer using CT gastrography and virtual gastroscopy was higher than EGC cases. However, CT gastrography and virtual gastroscopy showed less favorable results than UGIs. Even though only a small number of cases had been studied, we might conclude that CT gastrography and virtual gastroscopy could replace UGIs in the detection of AGC cases. Conclusion: The detection rate used with CT gastrography and Virtual gastroscopy is not better than that of UGIs in early gastric cancer, however, in advanced gastric cancer cases, it is nearly equal to that of UGIs.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.161-166
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• 2006

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 $5.3{\pm}2.9\;mm(range,\;0{\sim}23\;mm)$. 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.

• 대한위암학회:학술대회논문집
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• 2005.10a
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• pp.41-41
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• 2005