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



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


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.


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.


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.


Computed tomography Volumetry Gastrography Stomach Gastrectomy 



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.


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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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