Gastric Wall Thickness on Abdominal CT: The Association with Gastric Cancer Diagnosis

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Siriwan Thewthong

Abstract

Background: Gastric cancer is the third leading cause of cancer deaths worldwide. Detection of gastric wall thickening on Abdominal MDCT, which is an important characteristic found in gastric cancer would help the clinician to diagnose gastric cancer at an early stage, reduce metastasis and death rates of patients.
Objective: To evaluate the association of gastric wall thickness on Abdominal MDCT and the diagnosis of gastric cancer.
Methods: One hundred and thirty-six patients with gastric wall thickening identified by abdominal MDCT were enrolled. All patients performed abdominal MDCT and gastroscopy with biopsy for a period not exceeding 30 days. The gastric wall thickness, perigastric lymph nodes, ascites and carcinomatosis peritoneii were recorded.
Results: Among the 136 patients with gastric wall thickening, there were 93 cases of gastric cancer and 43 cases of non-malignant gastric disease. The mean gastric wall thickness between these groups were 24.9 ± 12.5 mm and19.9 ± 8.4 mm, respectively, which was statistically significant (p-value = 0.018). When using the gastric wall thickness of 12 mm, it was found that the sensitivity, specificity, accuracy, PPV and NPV of gastric cancer diagnosis was 100%, 9.3%, 71.3%, 70.5% and 100%, respectively and while gastric wall thickness is thicker than19.2 mm together with perigastric lymphadenopathy would improve gastric cancer diagnosis. Odds ratio = 2.8 [95% CI: 1.2, 6.3], p-value 0.014.
Conclusion: MDCT has a high accuracy in the diagnosis of gastric cancer when using the gastric wall thickness of more than 19.2 mm accompanies with perigastric adenopathy even though inadequate distended stomach. In addition, Abdominal MDCT provides useful information including ascites and carcinomatosis which helping diagnosis gastric cancer.
Keywords: Gastric wall thickness, Gastric cancer, Abdominal MDCT

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