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The image-guided gastrostomy techniques, as transoral and transabdominal, can be performed when there is a failure of the endoscopic procedure or in some specific clinical scenarios. This pictorial essay intends to show the percutaneous gastrostomy techniques, indications, technical approaches, post-procedure care, and complications.
As técnicas de gastrostomia guiadas por imagem, por via transoral e transabdominal podem ser realizadas quando há falha na técnica endoscópica ou em cenários clínicos em que a endoscopia não pode ser realizada. Este ensaio iconográfico pretende mostrar as técnicas de gastrostomia percutânea, suas indicações, aspectos técnicos, cuidados pós-procedimento e complicações.
RESUMEN
Resumo As técnicas de gastrostomia guiadas por imagem, por via transoral e transabdominal podem ser realizadas quando há falha na técnica endoscópica ou em cenários clínicos em que a endoscopia não pode ser realizada. Este ensaio iconográfico pretende mostrar as técnicas de gastrostomia percutânea, suas indicações, aspectos técnicos, cuidados pós-procedimento e complicações.
Abstract The image-guided gastrostomy techniques, as transoral and transabdominal, can be performed when there is a failure of the endoscopic procedure or in some specific clinical scenarios. This pictorial essay intends to show the percutaneous gastrostomy techniques, indications, technical approaches, post-procedure care, and complications.
RESUMEN
OBJECTIVE: To evaluate the accuracy of multidetector computed tomography with a stomach protocol in staging of gastric cancer. MATERIALS AND METHODS: We evaluated 14 patients who underwent computed tomography in a 16-channel scanner for preoperative staging of gastric adenocarcinoma between September 2015 and December 2016. All images were analyzed by the same radiologist, who had extensive experience in abdominal cancer imaging. The sensitivity, specificity, and accuracy of the method were calculated by comparing it with the pathology result. All patients underwent partial or total gastrectomy. RESULTS: The mean age was 61.5 years, and 53.8% of the patients were male. The gastric lesions were classified as T1/T2 in 35.7% of the cases, as T3 in 28.5%, and as T4 in 35.7%. Eleven patients (68.7%) had suspicious (N positive) lymph nodes. The accuracy of the T1/T2, T3, T4, and lymph node staging tests was 85%, 78%, 90%, and 78%, respectively. The respective sensitivity and specificity values were 71% and 100% for T1/T2, 66% and 81% for T3, 100% and 90% for T4, and 88% and 60% for lymph nodes. CONCLUSION: Multidetector computed tomography with a stomach protocol, used in conjunction with virtual gastroscopy, shows good accuracy in the tumor and lymph node staging of gastric adenocarcinoma.
RESUMEN
Abstract Objective: To evaluate the accuracy of multidetector computed tomography with a stomach protocol in staging of gastric cancer. Materials and Methods: We evaluated 14 patients who underwent computed tomography in a 16-channel scanner for preoperative staging of gastric adenocarcinoma between September 2015 and December 2016. All images were analyzed by the same radiologist, who had extensive experience in abdominal cancer imaging. The sensitivity, specificity, and accuracy of the method were calculated by comparing it with the pathology result. All patients underwent partial or total gastrectomy. Results: The mean age was 61.5 years, and 53.8% of the patients were male. The gastric lesions were classified as T1/T2 in 35.7% of the cases, as T3 in 28.5%, and as T4 in 35.7%. Eleven patients (68.7%) had suspicious (N positive) lymph nodes. The accuracy of the T1/T2, T3, T4, and lymph node staging tests was 85%, 78%, 90%, and 78%, respectively. The respective sensitivity and specificity values were 71% and 100% for T1/T2, 66% and 81% for T3, 100% and 90% for T4, and 88% and 60% for lymph nodes. Conclusion: Multidetector computed tomography with a stomach protocol, used in conjunction with virtual gastroscopy, shows good accuracy in the tumor and lymph node staging of gastric adenocarcinoma.
Resumo Objetivo: Avaliar a acurácia da tomografia computadorizada multidetectores com protocolo gástrico no estadiamento do câncer de estômago. Materiais e Métodos: Entre setembro de 2015 e dezembro de 2016, foram incluídos 14 pacientes com diagnóstico de adenocarcinoma gástrico que realizaram exame de tomografia computadorizada de 16 canais para estadiamento. As imagens foram analisadas por um mesmo radiologista, com experiência em imagem oncológica abdominal. Foram calculadas sensibilidade, especificidade e acurácia do método, comparando com o resultado anatomopatológico. Todos os pacientes foram submetidos a gastrectomia parcial ou total. Resultados: A idade média foi 61,5 anos, sendo 53,8% do sexo masculino. Em 35,7% dos casos as lesões gástricas foram classificadas como T1/T2, 28,5% como T3 e 35,7% como T4. Onze pacientes exibiam linfonodos suspeitos (N positivo), representando 68,7%. A acurácia do exame para estadiamento T1/T2, T3, T4 e linfonodal foi 85%, 78%, 90% e 78%, respectivamente. Os valores de sensibilidade e especificidade foram 71% e 100% para T1/T2, 66% e 81% para T3, 100% e 90% para T4 e 88% e 60% para linfonodos. Conclusão: A tomografia computadorizada multidetectores com protocolo gástrico associado ao estudo de gastroscopia virtual apresenta boa acurácia no estadiamento tumoral e linfonodal do adenocarcinoma gástrico.
