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Preoperative Staging of Gastric Adenocarcinoma: Comparison of Helical CT and Endoscopic US¹

¹ From the Departments of Diagnostic and Interventional Radiology (C.R.H., F.W., R.R., C.D., G.A.), General Surgery (H.H.), Interdisciplinary Endoscopy (S.B.), and Pathology (C.S.) and Institute for Mathematics and Computer Science in Medicine (V.S.), University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. From the 2000 RSNA scientific assembly. Received July 22, 2002; revision requested September 26; final revision received May 22, 2003; accepted June 16. Address correspondence to C.R.H. (e-mail: c.habermann@uke.uni-hamburg.de).

View larger version (168K): [in a new window]   Figure 1. Transverse CT image of a 75-year-old man with tumor in the body of the stomach (arrows) and transmural involvement with linear stranding in the perigastric fat (arrowhead). This tumor was correctly staged as T2.

View larger version (139K): [in a new window]   Figure 2a. Images of a 73-year-old-man. (a) Transverse CT image of an antral transmural tumor close to the gallbladder (arrow) with no infiltration of the gallbladder and no visible blurring (arrowhead). This tumor was staged as T2. (b) Endoscopic US image of the tumor (TU) in a corresponding plane with a transmural lesion and no wall thickening of the gallbladder (GB). This tumor was staged correctly as T2.

View larger version (88K): [in a new window]   Figure 2b. Images of a 73-year-old-man. (a) Transverse CT image of an antral transmural tumor close to the gallbladder (arrow) with no infiltration of the gallbladder and no visible blurring (arrowhead). This tumor was staged as T2. (b) Endoscopic US image of the tumor (TU) in a corresponding plane with a transmural lesion and no wall thickening of the gallbladder (GB). This tumor was staged correctly as T2.

View larger version (143K): [in a new window]   Figure 3. Transverse CT scan of a 47-year-old woman shows an antral tumor (arrows) with blurring of more than one-third of the tumor extent (arrowheads). The lesion was correctly staged as T3.

View larger version (123K): [in a new window]   Figure 4a. Images of a 52-year-old woman. (a) Transverse CT image of a transmural tumor of the antrum (arrows) with blurring and obliteration of the fat plane between the gastric wall and the liver and additional invasion of the liver (arrowhead). This tumor was correctly staged as T4. (b) Endoscopic US image that corresponds to a shows a tumor (arrows) involving the gastric wall and the adjacent liver (arrowhead). (GB = gallbladder).

View larger version (103K): [in a new window]   Figure 4b. Images of a 52-year-old woman. (a) Transverse CT image of a transmural tumor of the antrum (arrows) with blurring and obliteration of the fat plane between the gastric wall and the liver and additional invasion of the liver (arrowhead). This tumor was correctly staged as T4. (b) Endoscopic US image that corresponds to a shows a tumor (arrows) involving the gastric wall and the adjacent liver (arrowhead). (GB = gallbladder).