Gastric cancer (summary)

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This is a basic article for medical students and other non-radiologists

Gastric cancer, also known as stomach cancer or gastric carcinoma, refers to a cancer that arises from the mucosal lining of the stomach. It is the commonest gastric malignancy.

Reference article

This is a summary article; read more in our article on gastric cancer.

Summary

  • epidemiology
    • uncommon before the age of 40 years
    • incidence rises rapidly to the age of 70 years (median age)
  • presentation
    • 50% have no symptoms
    • non-specific symptoms in the early stages, e.g. dyspepsia
    • anorexia and weight loss
  • pathophysiology
    • adenocarcinoma is the commonest stomach cancer (95%)
    • associations with H. pylori
    • 10% genetic component
  • investigation
    • endoscopy used to visualize and biopsy
    • CT used for staging of metastatic disease
  • treatment
    • partial or total gastrectomy
    • +/- chemoradiotherapy

Role of imaging

Imaging is limited to the assessment of distant metastatic disease in stomach cancer. Plain radiograph and ultrasound are of limited value.

  • is there distant spread?

CT is the modality that is used for assessment of distant spread. PET/CT is used in some centers.

Radiographic features

CT
  • performed with negative contrast (distended with water or gas)
  • polypoid mass in the stomach
  • focal wall thickening
  • ulceration (gas-filled ulcer crater in the mass)
Fluoroscopy

Not used very much in standard practice, but can depict an irregular gastric surface and ulceration.

Medical student radiology curriculum