American Journal of Roentgenology, Vol 162, 329-334, Copyright © 1994 by American Roentgen Ray Society

ARTICLES

Diagnosis of gastric carcinoma: sensitivity of double-contrast barium studies

VH Low, MS Levine, SE Rubesin, I Laufer and H Herlinger
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.

OBJECTIVE. This study was undertaken to determine if the double- contrast upper gastrointestinal examination is a sensitive technique for diagnosing gastric carcinoma. MATERIALS AND METHODS. We retrospectively reviewed the radiographs of 80 patients with pathologically proved gastric carcinoma who had double-contrast barium studies of the upper gastrointestinal tract between 1985 and 1992. The original radiologic reports were also reviewed to determine if the lesions had been detected on radiographic studies and if a diagnosis of gastric carcinoma had been made or suspected on the basis of the results. Subsequently, radiologic records were reviewed to identify all patients who had double-contrast studies during a recent 1-year period for whom endoscopy was recommended for evaluation of possibly malignant lesions. Pathologic records were also reviewed to determine the number of true-positive and false-positive cases in this group. RESULTS. The lesions were detected radiographically in all 80 patients. In one case, however, the lesion had been missed on another barium study 2 years earlier, so that we actually detected 79 (99%) of the 80 gastric carcinomas. Malignant neoplasm was diagnosed or suspected in 77 cases (96%). In two of the three cases in which gastric carcinoma was not mentioned in the radiologic reports, the lesion caused gastric outlet obstruction. A separate 1-year retrospective review revealed that only 54 (3.5%) of 1546 patients who had double-contrast studies during this period were referred for endoscopy because of radiographic findings that were equivocal or suggestive of tumor. The presence of gastric carcinoma was confirmed by endoscopy or surgery in 10 (19%) of those 54 patients. CONCLUSION. Our findings indicate that the double-contrast upper gastrointestinal examination is a sensitive technique for the diagnosis of gastric carcinoma. Furthermore, a high sensitivity can be achieved without having an inordinate number of patients undergo unnecessary endoscopy.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. S. Levine, S. E. Rubesin, and I. Laufer Barium Studies in Modern Radiology: Do They Have a Role? Radiology, January 1, 2009; 250(1): 18 - 22. [Full Text] [PDF]

				R. M. Shideler, K. P. Banks, and E. Torres AJR teaching file: persistent epigastric pain. Am. J. Roentgenol., September 1, 2006; 187(3 Suppl): S480 - S482. [Full Text] [PDF]

				S. Bhalla Invited Commentary RadioGraphics, July 1, 2006; 26(4): 1117 - 1118. [Full Text] [PDF]

				E. K. Insko, M. S. Levine, B. A. Birnbaum, and J. E. Jacobs Benign and Malignant Lesions of the Stomach: Evaluation of CT Criteria for Differentiation Radiology, July 1, 2003; 228(1): 166 - 171. [Abstract] [Full Text] [PDF]

				N. Shindoh, T. Nakagawa, Y. Ozaki, S. Kyogoku, Y. Sumi, and H. Katayama Overlooked Gastric Carcinoma: Pitfalls in Upper Gastrointestinal Radiology Radiology, November 1, 2000; 217(2): 409 - 414. [Abstract] [Full Text]