Imaging diagnosis and value of early gastric cancer / 中国实用外科杂志

ABSTRACT

Radiology is one of the common modalities in the diagnosis and evaluation of early gastric cancer(EGC), which include X-ray double contrast radiography, CT, MRI and PET.X-ray double contrast radiography is a classical method on the diagnosis of EGC. High concentration of barium, with the combination of double contrast, mucosal and thin-layer flow-coating methods, can dynamically observe the three-dimensional morphology of mucosal surface damage. Abdominal enhanced CT is one of the conventional methods for the staging of EGC.Hypotonic air-filling is recommended, and the standardized application of late arterial phase(40 seconds) enhancement and multiplanar reconstruction(MPR) techniques is emphasized. The demonstration of the continuous and complete lowintensity bands between the inner high enhanced cancer layer and outer intermediate enhanced muscularis propria layer of gastric wall, or the thickness of the inner high enhanced cancer layer less than 50% of the total thickness of gastric wall,which were the CT signs of EGC. The latter sign is of greater importance in the staging diagnosis of EGC originated from peptic ulcers. Dual-energy CT has the potential to improve the detection and staging accuracy of EGC. DW-MRI and DCEMRI imaging can highlight the display of EGC and improve the detection. PET is limited in the detecting ability of EGC, but it can assist in predicting the curative treatment of endoscopic mucosal resection(ESD) of EGC and monitoring the recurrence after ESD. Periodic follow-up should be conducted after the operation of EGC, especially ESD procedures. The followup plan can be formulated according to the relevant risk factors. Radiomics has the potential in the diagnosis of lymph node metastasis in EGC.