Positioning During CT Gastrography in Patients with Gastric Cancer: the Effect on Gastric Distension and Lesion Conspicuity

OBJECTIVE: We wanted to prospectively evaluate the effect of various positions of the patient on gastric distension and lesion conspicuity during performance of CT gastrography (CTG). MATERIALS AND METHODS: One hundred thirteen consecutive patients with gastric cancer underwent CTG in the 30° left posterior oblique (LPO), supine, and prone positions. Two radiologists scored (a grade from 1-4) the degree of gastric distension and the lesion conspicuity according to the three scanning positions and the three gastric portions. Two- (2D) and three-dimensional (3D) images were used for analysis. Finally, these data were compared with the endoscopic findings and surgical results. RESULTS: The mean scores of gastric distension and lesion conspicuity for the LPO and supine positions were higher than those for the prone position (p < 0.001) in the gastric middle and lower portions. However, there was no significant difference between the LPO and supine positions (p ≥ 0.21). As for the gastric upper portion, the mean scores of gastric distension in the prone position were higher than those in the two other positions (p < 0.001). The prone position showed better lesion conspicuity than the two other positions for only one of two cases of gastric cancer in the upper portion of the stomach. CONCLUSION: CTG performed in the LPO position or the supine position combined with CTG performed in the prone position is optimal for achieving good gastric distension and evaluating the lesion conspicuity of gastric cancer.