Title: Multidetector Computerized Tomography --Is It Indispensable In Management of Gastric Carcinoma?
Authors: Dr Saritha K.R., Dr Suny Thomas, Dr Mohanan K., Dr Brahmadathan M.N., Dr Paul V. Puthussery, Dr Suma Job
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.69
Abstract
Introduction: The role of Multidetector Computerized Tomography (MDCT) in gastric carcinoma evaluation and management is a matter of debate. Early and accurate detection, staging and management significantly improve the prognosis.
Aim of the Study: To evaluate the efficacy of MDCT in comparison with the surgical and histopathological findings in gastric carcinoma.
Materials and Methods: 50 patients with diagnosed gastric adenocarcinoma were evaluated with MDCT. Staging was done and correlated with surgical and histopathological findings which were the gold standard. Various statistical calculations and significance are assessed.
Results: The sensitivity, specificity, positive and negative predictive values and accuracy of MDCT were calculated with regards to T staging, N staging, regional infiltration and metastases.
Conclusions: There was statistically significant correlation between MDCT and histopathological findings in T staging and N staging. Sensitivity was more in advanced carcinoma. The limitations in T staging were in differentiating T3 and T4 and in assessing regional infiltration. This was most probably due to the reduced intraabdominal fat in thin, cachexic patients. The incidence of micro metastases in normal sized lymph nodes and reactive enlargement of lymph nodes were the limitations in N staging. MDCT can reliably rule out metastases. Overall, MDCT is a highly reliable tool in accurate staging of gastric carcinoma, which helps in accurate management and improves prognosis.
Keywords: multidetector computerized tomography, gastric carcinoma.
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