Utility of multidetector CT in the diagnosis of gastric bare area invasion by proximal gastric carcinoma

Purpose To investigate the utility of multidetector CT (MDCT) in the diagnosis of gastric bare area (GBA) invasion by proximal gastric carcinoma (PGC). Methods Sixty-eight consecutive patients with biopsy-proven PGC underwent MDCT scan prior to gastrectomy. We evaluated the CT images separately for the site, size, depth, lymph node, and enhancement characteristic of each case. Each postsurgical stomach specimen was axially sectioned and comparison was made to determine the correlation between the CT findings and the pathological examination of each tumor bearing slice. Results The sensitivity for detecting GBA involvement in patients with PGC was 84%. MDCT correctly identified 32 of 38 patients with GBA invasion and 10/13 (77%) tumors with metastatic lymph node greater than 5 mm in GBA or subphrenic retroperitoneal space. 33/36 (92%) patients with tumor extension within the edge of the gastric wall and 28/32 (88%) patients with tumor infiltration into subphrenic fat were correctly identified. MDCT correctly predicted the infiltration of tumor into the diaphragm in all 14 patients and identified 6/11 (55%) patients with gastrophrenic ligament invasion. Conclusion MDCT may be of value in assessing the important radiological characteristics of GBA invasion in patients with PGC.