CT colonography for postoperative surveillance after curative gastrectomy in patients with gastric cancer.
OBJECTIVE
The purpose was to evaluate the diagnostic role of contrast-enhanced CT colonography (CTC) for follow-up of colorectal cancer screening after curative gastrectomy in patients with gastric adenocarcinomas.


METHODS
Contrast-enhanced CTC was performed as a substitute for routine follow-up CT for the detection of recurrent lesions in 700 consecutive patients who underwent curative surgery for gastric adenocarcinomas. Prospectively, patients with polyps measuring 6 mm or larger on CTC were referred for optical colonoscopy. Clinical and radiologic follow-up with respect to detection of polyp and recurrent lesion was retrospectively assessed.


RESULTS
Colorectal polyps measuring 6 mm or larger were identified by CTC in 104 (14.9%) of the 700 patients. Optical colonoscopy was recommended to these patients and was performed in 72 cases. True positive lesions were identified in 62 of the 72 patients (per-patient positive predictive value: 86.1%). The diagnostic yield for primary colonic malignancies was 1.6% (11/700). Recurrent lesions of gastric cancer were also detected in eight patients (1.1%).


CONCLUSIONS
In patients who undergo gastrectomy due to gastric adenocarcinoma, contrast-enhanced CTC may offer a unique advantage by allowing simultaneous colorectal cancer screening in addition to its routine role of detecting recurrent lesions during follow-up.
Lim
Joon Seok
JS
Department of Radiology, Yonsei University Health System, Seoul, Republic of Korea.
Lee
Sang Kil
SK
Hyung
Woo Jin
WJ
Choi
Jin-Young
JY
Kim
Myeong-Jin
MJ
Noh
Sung Hoon
SH
Kim
Ki Whang
KW
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000000981:diagnostic imaging; D023881:Colonography, Computed Tomographic / Q000379:methods*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D003287:Contrast Media; D055088:Early Detection of Cancer; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011182:Postoperative Care; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery
D003287:Contrast Media