Preoperative Evaluation of Advanced Gastric Cancer by Three-Dimensional Computed Tomographic Virtual Gastroscopy

Purpose: To assess the role of three-dimensional (3D) computed tomographic virtual gastroscopy (CTVG) in the diagnosis of advanced gastric cancer. Methods: Forty-eight patients (mean age,58 years; range, 23-68 years; 30 men, 18 women) with advanced gastric cancer were evaluated by gastrifiberscopy with biopsies and 3D CTVG. The accuracy of CTVG for localization, classfication and staging of gastr ic cancer was determined, compared with gastrifiberscopy and histopathology. Results: Among 48 patients, the findings were confirmed in 40 at surgery. In the remaining cases, the findings were confirmed by gastric fiberscopy and biopsy specimen. The 3D CTVG accurately detected the localization in all the 48 (100%) patients with advanced gastric cancer. The overall accuracy of 3D CTVG for classfication of gastric lesions was 90% (36/40), with 4 overstaged lesions in the pre-operative determination of Borrmann types. The 3D CTVG was more specific than gastric fibers copy in depicting infiltration of neoplas m (78.6% vs 63.4%) (p = 0.042). Conclusion: 3D CTVG is helpful in the detection and evaluation of advanced gastric cancer and is a promising method for evaluating gastric lesion despite its limitations.