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Abdominal Radiology

, Volume 41, Issue 10, pp 1899–1905 | Cite as

CT gastrography for volumetric measurement of remnant stomach after distal gastrectomy: a feasibility study

  • Jimi Huh
  • In-Seob Lee
  • Kyung Won KimEmail author
  • Jisuk Park
  • Ah Young Kim
  • Jong Seok Lee
  • Jeong-Hwan Yook
  • Byung-Sik Kim
Article
  • 446 Downloads

Abstract

Purpose

To evaluate the feasibility of post-operative CT gastrography for volumetry of the remnant stomach in gastric cancer patients treated with distal gastrectomy.

Methods

CT gastrography was performed with oral administration of effervescent granules in 35 gastric cancer patients who underwent distal gastrectomy. Two readers independently rated the degree of gastric distension on a four-point scale, one (near-total collapse) to four (well distended) and measured the volume of remnant stomach using either 3D or 2D volumetry. The inter-volumetry agreements between the 2D and 3D methods and the interobserver agreements between readers 1 and 2 were assessed by intraclass correlation coefficients (ICCs) and Bland–Altman plots.

Results

The mean score of gastric distension was 3.4 ± 0.6 points and 3.4 ± 0.7 points from readers 1 and 2, respectively. We regarded CT images scored with 3–4 points as a technical success for reliable CT volumetry, which achieved a rate of 91.4% (32/35). For the inter-volumetry agreements between 3D and 2D volumetry, the ICCs were 0.9778 and 0.9814 from readers 1 and 2, respectively. The interobserver agreement between readers 1 and 2 was also excellent, with ICCs of 0.9961 and 0.9876 for 2D and 3D volumetry, respectively. On Bland–Altman plots, the means of differences between any pairs of volumetry measurements ranged from −31.1 to 3.2 cm3, which may be an acceptable range of measurement variability.

Conclusions

Post-operative CT gastrography is feasible in patients treated with distal gastrectomy. Both 2D and 3D volumetry methods are comparable in measuring the remnant stomach volume.

Keywords

Computed tomography Volumetry Gastrography Stomach Gastrectomy 

Notes

Funding

This research was supported by Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant No. HI14C1090).

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

References

  1. 1.
    Lee J, Hur H, Kim W (2010) Improved long-term quality of life in patients with laparoscopy-assisted distal gastrectomy with jejunal pouch interposition for early gastric cancer. Ann Surg Oncol 17:2024–2030. doi: 10.1245/s10434-010-1095-z CrossRefPubMedGoogle Scholar
  2. 2.
    Adachi Y, Suematsu T, Shiraishi N, et al. (1999) Quality of life after laparoscopy-assisted Billroth I gastrectomy. Ann Surg 229:49–54CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Aoyama T, Kawabe T, Hirohito F, et al. (2015) Body composition analysis within 1 month after gastrectomy for gastric cancer. Gastric Cancer . doi: 10.1007/s10120-015-0496-x Google Scholar
  4. 4.
    Namikawa T, Oki T, Kitagawa H, et al. (2012) Impact of jejunal pouch interposition reconstruction after proximal gastrectomy for early gastric cancer on quality of life: short- and long-term consequences. Am J Surg 204:203–209. doi: 10.1016/j.amjsurg.2011.09.035 CrossRefPubMedGoogle Scholar
  5. 5.
    Obeidat FW, Shanti HA, Mismar AA, et al. (2014) Volume of resected stomach as a predictor of excess weight loss after sleeve gastrectomy. Obes Surg 24:1904–1908. doi: 10.1007/s11695-014-1330-y CrossRefPubMedGoogle Scholar
  6. 6.
    Saito T, Kurokawa Y, Takiguchi S, et al. (2014) Current status of function-preserving surgery for gastric cancer. World J Gastroenterol 20:17297–17304. doi: 10.3748/wjg.v20.i46.17297 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Lim MC, Tan CH, Cai J, et al. (2014) CT volumetry of the liver: where does it stand in clinical practice? Clin Radiol 69:887–895. doi: 10.1016/j.crad.2013.12.021 CrossRefPubMedGoogle Scholar
  8. 8.
    Karcz WK, Kuesters S, Marjanovic G, et al. (2009) 3D-MSCT gastric pouch volumetry in bariatric surgery-preliminary clinical results. Obes Surg 19:508–516. doi: 10.1007/s11695-008-9776-4 CrossRefPubMedGoogle Scholar
  9. 9.
    Pawanindra L, Vindal A, Midha M, et al. (2015) Early post-operative weight loss after laparoscopic sleeve gastrectomy correlates with the volume of the excised stomach and not with that of the sleeve! Preliminary data from a multi-detector computed tomography-based study. Surg Endosc 29:2921–2927. doi: 10.1007/s00464-014-4021-9 CrossRefPubMedGoogle Scholar
  10. 10.
    Robert M, Pechoux A, Marion D, et al. (2015) Relevance of Roux-en-Y gastric bypass volumetry using 3-dimensional gastric computed tomography with gas to predict weight loss at 1 year. Surg Obes Relat Dis 11:26–31. doi: 10.1016/j.soard.2014.05.014 CrossRefPubMedGoogle Scholar
  11. 11.
    Vidal P, Ramon JM, Busto M, et al. (2014) Residual gastric volume estimated with a new radiological volumetric model: relationship with weight loss after laparoscopic sleeve gastrectomy. Obes Surg 24:359–363. doi: 10.1007/s11695-013-1113-x CrossRefPubMedGoogle Scholar
  12. 12.
    Blanchet MC, Mesmann C, Yanes M, et al. (2010) 3D gastric computed tomography as a new imaging in patients with failure or complication after bariatric surgery. Obes Surg 20:1727–1733. doi: 10.1007/s11695-010-0256-2 CrossRefPubMedGoogle Scholar
  13. 13.
    Kim HJ, Kim AY, Lee JH, et al. (2009) Positioning during CT gastrography in patients with gastric cancer: the effect on gastric distension and lesion conspicuity. Korean J Radiol 10:252–259. doi: 10.3348/kjr.2009.10.3.252 CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Buchwald H, Avidor Y, Braunwald E, et al. (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292:1724–1737. doi: 10.1001/jama.292.14.1724 CrossRefPubMedGoogle Scholar
  15. 15.
    Lee SJ, Chong S, Kang KH, et al. (2014) Semiautomated thyroid volumetry using 3D CT: prospective comparison with measurements obtained using 2D ultrasound, 2D CT, and water displacement method of specimen. AJR Am J Roentgenol 203:W525–W532. doi: 10.2214/AJR.13.12206 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Jimi Huh
    • 1
    • 3
  • In-Seob Lee
    • 2
  • Kyung Won Kim
    • 1
    Email author
  • Jisuk Park
    • 1
  • Ah Young Kim
    • 1
  • Jong Seok Lee
    • 1
  • Jeong-Hwan Yook
    • 2
  • Byung-Sik Kim
    • 2
  1. 1.Department of Radiology, Bioimaging Center, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  2. 2.Department of Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  3. 3.Department of Radiology, University of Ulsan College of MedicineUlsan University HospitalUlsanRepublic of Korea

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