Role of Double-Phase Spiral CT for T Staging of Gastric Cancer: Radiologic-Pathologic Correlation

URPOSE: To evalvate the role of double-phase spiral CT for T staging of gastric cancers with radiologic-pathologic correlation. MATERIALS AND METHODS: Double-phase spiral CT images of 44 patients of gastriccancers proved by pathologic examination were retrospectively evaluated. We retrospectively classified spiral CTimages of gastric cancers ; classification was from S 0 to S 4 and was based on the degree of change in three multilayered patterns shown in normal gastric wall and whether or not tumor cells had invaded perigastric fattissue. Pathologic classification was based on the T staging of TNM classification for gastric cancers, and wethen correlated these results. RESULTS: In group S1, all of three cases(100%) were proved to be T1 and in groupS2, five(45.5%) of 11 cases were T2. Of five cases with S3 CT findings, three(60%) were proved to be T3s andtwo(40%) were T2. Of 22 cases with S4 CT findings, 19(86.4%) were T3p. Overall sensitivity, specificity, and accuracy were 60.3%, 88. 5%, and 86.9%, respectively. In 35 (79.5%) of the total of 44 cases, the lesions were more enhanced on venous than on arterial phase. CONCLUSION: The accuracy of double-phase spiral CT for T staging of gastric cancers was 86.9%, and in contrast to previous results for conventional or dynamic CT, this level of accuracy was thought to be relatively high. In conclusion, double-phase spiral CT images of gastric cancers were helpful in the diagnosis of T staging.

Intratumoral Gas Formation of HCC after Trancatheter Arterial Chemoembolization (TACE)

PURPOSE: To determine the factors predisposing to the intratumoral gas formation after TACE in the treatment of HCC. MATERIALS AND METHODS: A total of 176 pathologically or clinically proven patients with HCC on whom CT scan had been performed in 2 weeks to 3months after TACE were reviewed. The patients were classified in two groups; intratumoral gas-forming group(n=18) and non-gas forming group(n=158). Chi-square (X2) test was applied to analyze the factors influencing to gas formation. The radiological factors studied were the morphologic type and location of HCC, presence or absence of tumor capsule on CT, the degree of tumor vascularities, presence or absence of portal vein thrombosis, presence or absence of arterioportal shunt, and TACE catheterization method on angiegraphic examination and the duration of post-TAE fever. RESULT: Intratumoral gas foramtion after TACE occurred significantly in tumors with peripheral location or capsule on CT tumors with less vascularity or peripheral arterioportal shunt on angiegraphic examination, and TACE with selective catheterization method(p0.05). The average duration of fever sustained after TACE was longer in gas-forming group than those in non-gas forming group (p<0.05). CONCLUSION: TACE of HCC with weak collaterals or with peripherd prevent recanalization from collaterals has tendency to intratumoral gas form-his and prolonged fever duration.