Preoperative Role of Dynamic Abdominal Computed Tomography in Gastric Tumors

INTRODUCTION: Gastric cancer accounts for nearly half a million deaths each year all over the world. Dynamic abdominal CT is used for preoperative diagnosis and staging of gastric cancers. Preoperative staging must be done correctly, so the patient can get the proper treatment options such as neoadjuvan chemotherapy. To further clarify of preoperative role of dynamic abdominal CT; we compared preoperative CT findings with postoperative, and histopathological findings.
METHODS: Patients’ records, who underwent gastric operation for gastric cancer, between 2016 to 2019 were analyzed retrospectively. All preoperative CT findings were compared with surgical and histopathological findings statistically, and also preoperative CT images were evaluated by another radiologist postoperatively.
RESULTS: For 3 year period total 103 patients were diagnosed and operated for gastric cancer in our clinic. The population was comprised of 76 (73.7%) male and 25(24.2%) female patients who were averagely 67 years old. All of the patþents have preoperative dynamic abdominal CT. Preoperative CT findings for staging and also diagnosis were insufficient for 16 (15.84 %) patients of 101. The treatment options, mortality and morbidity rates for 16 patients did not change, because additional imaging technics (PET CT, MRI, EUS) and endoscopy were performed to these patients preoperatively.
DISCUSSION AND CONCLUSION: Dynamic abdominal CT has a major role for preoperative diagnosis and staging of gastric tumors, but some cases could be misevaluated, so that preoperative evaluation of gastric tumors should be done with dynamic CT and if necessary MRI, PET CT, EUS or endoscopy.

Gastrik Tümörlerde Dinamik Abdominal Bilgisayarlý Tomografinin Preoperatif Rolü

GÝRÝÞ ve AMAÇ: Mide kanseri tüm dünyada her yýl yaklaþýk yarým milyon hastanýn ölümüne neden olmaktadýr. Dinamik abdominal BT preoperatif taný ve mide kanserlerinin evrelemesinde yaygýn olarak kullanýlmaktadýr. Burada en önemli nokta preoperatif evrelemenin doðru yapýlarak, hastalarýn neoadjuvan kemoterapi gibi uygun tedavi seçeneklerine kavuþabilmesidir. Dinamik abdominal BT'nin preoperatif rolünü daha da netleþtirmek için; preoperatif BT bulgularýný postoperatif ve histopatolojik bulgular eþliðinde karþýlaþtýrdýk.
YÖNTEM ve GEREÇLER: Mide kanseri nedeniyle 2016 - 2019 yýllarý arasýnda operasyon geçiren hastalarýn kayýtlarý geriye dönük olarak incelendi. Tüm preoperatif BT bulgularý cerrahi bulgularla istatistiksel olarak karþýlaþtýrýldý ve preoperatif BT görüntüleri ameliyat sonrasý baþka bir radyolog tarafýndan deðerlendirildi.
BULGULAR: Üç yýl boyunca kliniðimizde toplam 103 hastaya mide kanseri tanýsý konuldu ve opere edildi. Ýncelenen hastalarýn 76 'sý (% 73.7) erkek ve 25' i (% 24.2) kadýndý ve ortalama yaþ 67' idi.Tüm hastalara preoperatif dinamik abdominal BT inceleme yapýldý. Preoperatif BT bulgularý evreleme ve taný için ayrýca hastanýn 16' sýnda (% 15.84) yetersizdi. Bu 16 hastanýn ek görüntüleme teknikleri (PET CT, MR, EUS) ve endoskopi nedeniyle tedavi seçenekleriyle, mortalite ve morbidite oranlarý deðiþmedi.
TARTIÞMA ve SONUÇ: Dinamik abdominal BT' nin mide tümörlerinde preoperatif taný ve evrelemesinde önemli bir rolü vardýr, ancak bazý vakalar yanlýþ deðerlendirilebildiði veya gözden kaçabildiði görülmektedir. Bu yüzden mide tümörü düþünülen hastalarda preoperatif evreleme yapýlýrken BT yanýnda primer olarak endoskopi ve sonrasýnda MRI, PET, EUS gibi ek görüntüleme yöntemleriyle deðerlendirilmesi önemli olarak görülmektedir.