Tuesday, February 22, 2005

Jounal Club

CT virtual endoscopy of the stomach: comparison study with gastric fiberscopy.
Inamoto K, Kouzai K, Ueeda T, Marukawa T.

BACKGROUND: We evaluated the value of computed tomographic (CT) gastric virtual endoscopy (VE) by comparing it with real gastric fiberscopy (GF).
METHODS: Sixty-six VE findings in 63 patients were compared with lesions found with GF. After a GF examination, the examinees were given bubble-making granules for the stomach and placed in a supine position on the CT table. Abdominal CT slices of 1 mm thickness were obtained by multidetector row CT (Siemens Sensation 16) and reconstructed to VE images with volume and surface rendering on the same day.
RESULTS: VE images were successful in showing subtle alterations in the gastric mucosal folds. Gastric cancer, polyps, ulcers, erosions, and gastritis were clearly visualized. Comparison studies between VE and GF (as the gold standard) showed a sensitivity of 92.7% and a specificity of 90.9%. Original CT images were also useful in detecting lesions in other abdominal organs such as the liver, adrenal gland, and kidney.
CONCLUSION: Because VE is a good noninvasive screening method, except for minimal radiation exposure, it is expected to become a new technique for stomach examinations.

Abdom Imaging. 2005 Feb 1; [Epub ahead of print]


Anonymous said...

not to mention the advantage of avoidance of sedation in some cases, especially for kids

but it's another burden on CT's likely taking longer to get, adding another step to get a report vs directly visualizing by GI,
more importantly no ability to biospy lesions, particularly the ulcers that require biopsy in the stomach, no chance to biospy for h. pylori or to get snip of or look at the esophagus on the way out...
I know this study is suggesting screening use but a screening scope can instantly be a fully diagnostic test if it is needed, eliminating an entire step that would have been added if a lesion was picked up on CT. Same sort of argument with the virtual colonoscopy vs actual scope. (but with higher procedure risk in the colonoscopy) Both good debates though as screening is becoming more important to the patients and as their numbers increase we need to find the best most cost effective tests.


Anonymous said...

that was a well made point! inability to get a histopathological diagnosis on CT is a definite setback!

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