Accuracy of Spiral CT in Preoperative Staging of Gastric Carcinoma: Correlation with Surgical and Pathological Findings
Nittaya Chamadol MD*, Jitraporn Wongwiwatchai MD*, Vajarapongsa Bhudhisawasd MD**, Chawalit Pairojkul MD***
Affiliation : * Departments of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen ** Departments of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen *** Departments of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen
Objective : To assess the accuracy of spiral CT scan in the preoperative staging of gastric carcinoma by
comparing it with surgical/pathological staging.
Material and Method: Twenty-eight patients with gastric carcinoma who underwent both preoperative CT
scan and surgery were retrospectively studied for TNM classification. All CT scans were reviewed for tumor
location, gastric wall thickness, tumor extension, N1 and N2 nodal involvement, and metastases to the liver,
peritoneum and lung.
Results : Spiral CT staging was correct in 20 of 28 patients (71.4%). The preoperative CT scan had 96.1%
sensitivity, 100% specificity and 96.4% accuracy for evaluating serosal invasion. The sensitivity, specificity
and accuracy for assessing pathologic lymph node involvement were 73.1, 50.0 and 84.2 percent, respectively.
In the present study, peritoneal metastasis could not be identified by CT, but CT had 100% sensitivity for
evaluating hepatic metastases.
Conclusion : Spiral CT is a useful modality for preoperative staging of gastric carcinoma with high accuracy
for evaluating serosal invasion and hepatic metastases.
Keywords : Gastric carcinoma, Staging, Spiral CT
