Evaluation of the sensitivity of the double-contrast upper gastrointestinal series in the diagnosis of gastric cancer.

OBJECTIVE: To evaluate the sensitivity, specificity and accuracy of the double-contrast upper gastrointestinal series (UGI series) in the diagnosis of gastric cancer. MATERIAL AND METHOD: The authors retrospectively reviewed the radiographs of the double-contrast UGI series for diagnosis of gastric cancer of 84 patients who had pathological confirmation by gastric biopsies and/or operations. RESULTS: The lesions were true positive in 45 patients, true negative in 28 patients, false positive in 8 patients and false nagative in 3 patients. The authors found pathologically proved gastric cancers in 48 patients. They were 42 adenocarcinomas (87.5%), 3 gastric mucosa-associated lymphoid tissue lymphomas (6.2%), one gastrointestinal stromal tumor (2.1%), one squamous cell carcinoma at the distal esophagus involving the cardia (2.1%) and one cancer of the pancreatic head with invading gastric antrum (2.1%). The sensitivity, specificity and accuracy of the present study were 93 per cent, 77 per cent and 86 per cent, respectively. They showed small differences compared to the previous studies. CONCLUSION: The present findings indicate that the double-contrast UGI series has high sensitivity, specificity and accuracy. It should be considered a sensitive technique and initial examination in the diagnosis of gastric cancer.

Evaluation of the necessity of the three-film abdominal series in the diagnosis of abdominal pain.

The routine plain-film abdominal series, consisting of supine and upright abdominal radiographs and upright chest radiograph of 246 patients, who presented with abdominal pain from the emergency room of Bangkok Metropolitan Administration Medical College and Vajira Hospital from January 2000 to May 2001 were reviewed. Each radiograph was independently interpreted to detect any radiographic abnormality. Radiographic abnormalities were detected in 35 per cent on abdominal films and 13 per cent on chest films. The supine abdominal views could diagnose abnormalities in 84 per cent of these patients while the upright views diagnosed abnormalities in only 16 per cent of these cases. Most of the detectable abnormalities in the upright views were pneumoperitoneums that were clearly demonstrated on the upright chest radiographs. So elimination of the upright abdominal view from the routine plain-film abdominal series in the screening of surgical cases from medical cases could result in cost-saving and a decrease in radiation exposure without significant loss of diagnostic information.