Diagnosis and Evaluation of Scirrhous Gastric Cancer by CT, MRI and PET Satoshi Nozu 1 , Tatsuya Wada 1 , Tatsuo Yamauchi 2 1Department of Diagnostic Radiology, Saitama Cancer Center, Saitama, Japan 2Department of Radiological Technology, Saitama Cancer Center, Saitama, Japan Keyword: scirrhous gastric cancer , computed tomography , MRI , PET , distant metastasis pp.803-819
Published Date 2020/5/25
DOI https://doi.org/10.11477/mf.1403202054
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 CT(Computed tomography), MRI, and PET imaging findings have various functionalities in treating scirrhous gastric cancer, including cancer progression for preoperative findings, evaluation of response to treatment, and prediction of the prognosis. The characteristic layer pattern on multiphasic contrast-enhanced CT and diffusion-weighted magnetic resonance imaging are beneficial in the diagnosis of scirrhous gastric cancer.

 In the evaluation of cancer progression, CT scan is mainly used before cancer therapy, and 3D CT angiography enables surgeons to assess vascular anatomy before gastrectomy.

 Unlike CT and PET scan, MRI is not suitable for a wide range of examinations. MRI using Gd-EOB-DTPA is specifically useful in the diagnosis of liver metastasis. MRI is also helpful in the diagnosis of bone metastasis without bone destruction, which is difficult to diagnose by CT.

 Although the general role of PET in scirrhous gastric cancer is limited due to low sensitivity of lymph node and peritoneal metastases, it is useful in detecting distant metastasis. Our study of FDG-PET for scirrhous gastric cancer illustrated a median progression-free survival after gastrectomy of 1124 days in metastatic lymph node SUVmax <4 group of 8 patients and 742 days in SUVmax≧4 group of 49 patients(p<0.05).

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