Cross sectional imaging of the upper gastrointestinal tract

The initial diagnosis of oesophageal and gastric malignancy was traditionally made by radiologists using barium examinations. The increasing availability of endoscopy now means that most tumours are diagnosed by clinicians and the role of radiology has changed to staging the disease prior to surgery. Studies from the early 1980s suggested that computed tomography (CT) could be an accurate method of assessing gastric tumours.([1,2]) Work from the late 1980s([3]) however found CT to be quite inaccurate with up to 47 % of patients being incorrectly staged in one trial. The introduction of helical CT scanning has resulted in considerable improvement in evaluating the primary tumour and the presence of nodal and metastatic spread. CT now offers accurate staging of oesophageal and gastric carcinomas and is the mainstay of cross sectional imaging of the upper gastrointestinal tract with magnetic resonance imaging (MRT) and endoscopic ultrasound (EUS) having a complimentary role in certain specific aspects.