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Abdominal BT ile Mide Antrumu Duvar Kalınlığının Analizi: Benin ve Malin Patolojileri Ayırt Etmede Yüksek Tanısal Doğruluk

Year 2025, Volume: 3 Issue: 3, 13 - 20, 29.10.2025
https://doi.org/10.61678/bursamed.1605170

Abstract

Amaç: Mide kanserinin mümkün olan en erken aşamada teşhis edilmesi ve uygun tedaviye başlanması, hastaların uzun süreli sağkalımı için hayati bir önem taşımaktadır. Bu çalışmada, abdominal bilgisayarlı tomografi (BT) tetkikinde ölçülen antrum duvar kalınlığının endoskopik ve patolojik değerlendirme sonuçlarıyla karşılaştırmalı analizi gerçekleştirilmiştir. Amacımız benin ve malin durumları ayırt edebilecek optimal duvar kalınlığı kesim değerini belirleyerek
klinik uygulamalarda tanı sürecini hızlandırmak ve doğru tedavi yöntemlerinin belirlenmesine yardımcı olmaktır.
Yöntem: Şubat 2023 ile Ocak 2024 tarihleri arasında, endoskopik olarak antrum duvar örneklemesi yapılmış ve endoskopiden önceki veya sonraki 2 ay içinde abdominal BT tetkiki gerçekleştirilmiş olan 213 hasta çalışmaya dahil edilmiştir. Hastaların yaş, cinsiyet gibi demografik özellikleri ile birlikte abdominal BT tetkiklerinden ölçülen antrum duvar kalınlıkları, histopatolojik sonuçlarla retrospektif olarak karşılaştırılmıştır. Ayrıca benin ile malin patolojilerin ayrımında ROC analizi kullanılarak kesim değeri belirlenmiş, duyarlılık ve özgüllük oranları hesaplanmıştır.
Bulgular: Çalışmaya dahil edilen 213 hastanın 126’sı erkek, 87’si kadındır ve ortalama yaşları 60.8 yıldır. Bu hastaların 94’ü (60 erkek, 34 kadın; ortalama yaş 66.1 yıl) malin, 119’u (66 erkek, 53 kadın; ortalama yaş 56.6 yıl) ise benin olarak değerlendirilmiştir (p < 0.001). Antrum kalınlığı açısından malin ve benin durumların ayrımı için 12 mm kesim değeri kullanıldığında, duyarlılık %100 ve özgüllük %95.7 olarak bulunmuştur.
Sonuç: Optimal koşullarda elde edilen abdominal BT tetkiklerinde yapılan antrum duvar kalınlığı ölçümü, bu bölgeden kaynaklanabilecek benin ve malin patolojilerin ayrımı konusunda önemli bilgiler sağlamakta, böylece mide kanserinin erken teşhisinde ve tedavi sürecinde kritik bir rol oynamaktadır.

Ethical Statement

In this retrospective study, computed tomography images and endoscopic pathology data were used and no retrospective permission was requested from the ethics committee

References

  • Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(06):394–424
  • Levine MS, Megibow AJ, Kochman ML. Carcinoma of the stomach and duodenum. In: Gore RM, Levine MS (Eds.). Textbook of gastrointestinal radiology. 2nd edition Philadelphia: Saunders Elsevier; 2008: 619-43.
  • Thrumurthy SG, Chaudry MA, Hochhauser D, Mughal M. The diagnosis and management of gastric cancer. BMJ. 2013 Nov 4;347:f6367.
  • Hallinan JT, Venkatesh SK. Gastric carcinoma: imaging diagnosis, staging and assessment of treatment response. Cancer Imaging. 2013 May 30;13(2):212-27.
  • Dixon M, Cardoso R, Tinmouth J, Helyer L, Law C, Swallow C, et al. What studies are appropriate and necessary for staging gastric adenocarcinoma? Results of an international RAND/UCLA expert panel. Gastric Cancer 2014 Apr;17(2):377-82.
  • Coburn N, Seevaratnam R, Paszat L, Helyer L, Law C, Swallow C, et al. Optimal management of gastric cancer: results from an international RAND/UCLA expert panel. Ann Surg 2014 Jan;259(1):102–8
  • Shen Y, Kang HK, Jeong YY, Heo SH, Han SM, Chen K, et al. Evaluation of Early Gastric Cancer at Multidetector CT with Multiplanar Reformation and Virtual Endoscopy. Radiographics 2011 Jan-Feb;31(1):189-99.
  • Akagi T, Shiraishi N, Kitano S. Lymph node metastasis of gastric cancer. Cancers (Basel) 2011 Apr 26;3(2):2141-59.
  • Fawzi SY, Momjian RLB, Khaleel IA. The Role of Spiral Computed Tomography in the Detection & Staging of Gastric Malignancy. IJGE Issue 5 Vol 1 2005
  • Zytoon A, El-Atfey S & Hassanein SH. Diagnosis of gastric cancer by MDCT gastrography: diagnostic characteristics and management potential. Egypt J Radiol Nucl Med 51, 30 (2020).
  • Makino T, Fujiwara Y, Takiguchi S, Tsuboyama T, Kim T, Nushijima Y et al. Preoperative T staging of gastric cancer by multi-detector row computed tomography. Surgery.2011 May;149(5):672–9.
  • Pickhardt PJ, Asher DB. Wall thickening of the gastric antrum as a normal finding: multidetector CT with cadaveric comparison. AJR Am J Roentgenol 2003 Oct;181(4): 973-9.
  • Kul S, Sert B, Sari A, Arslan M, Kosucu P, Ahmetoglu A, et al. Effect of subclinical Helicobacter pylori infection on gastric wall thickness: multislice CT evaluation. Diagn Interv Radiol 2008 Sep;14(3): 138-42.
  • Cho SG, Kim WH, Lee KH, Kim MY, Han H, Ok CS, et al. Wall thickening of the gastric antrum: Is it a pseudolesion or a tumor? J Korean Radiol Soc 1999 Feb;40(2): 281-7.
  • Matzek W, Bastati N, Baroud S, Muin D, Herold C, Ba-Ssalamah A, et al. The Value of HMDCT in Differentiation between Normal and Pathologic Antral Wall Thickening of the Stomach. Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, Nov 28-Dec 3, 2010,Chicago IL.
  • Yavuz A, Akdemir Z, Bora A, Alptekin C, Dülger AC. Abdominal Bilgisayarlı Tomografi Tetkikinde Ölçülen Mide Antropilor Cidar Kalınlığının Benin ve Malin Mide Patolojilerinin Ayırımındaki Etkinliği. Van Tıp Dergisi 2015;22(3): 166-172.
  • Tongdee R, Kongkaw L, Tongdee T. A study of wall thickness of gastric antrum: comparison among normal, benign and malignant gastric conditions on MDCT scan. J Med Assoc Thai. 2012 Nov;95(11):1441-8.
  • Insko EK, Levine MS, Birnbaum BA, Jacobs JE. Benign and malignant lesions of the stomach: evaluation of CT criteria for differentiation. Radiology 2003 Jul;228(1):166-71.
  • Barros RH, Penachim TJ, Martins DL, Andreollo NA, Caserta NM. Multidetector computed tomography in the preoperative staging of gastric adenocarcinoma. Radiol Bras. 2015 Mar-Apr;48(2):74-80.
  • Chen CY, Wu DC, Kang WY, Hsu JS. Staging of gastric cancer with 16-channel MDCT. Abdom Imaging. 2006 Sep-Oct;31(5):514–20. Epub 2006 Feb 7. Erratum in: Abdom Imaging. 2014 Apr; 39(2):440.
  • Balfe DM, Koehler RE, Karstaedt N, Stanley RJ, Sagel SS. Computed tomography of gastric neoplasms. Radiology 1981 Aug; 140(2): 431-6.

Analysis of Gastric Antrum Wall Thickness by Abdominal CT: High Diagnostic Accuracy in Differentiating Benign and Malignant Pathologie

Year 2025, Volume: 3 Issue: 3, 13 - 20, 29.10.2025
https://doi.org/10.61678/bursamed.1605170

Abstract

are crucial for achieving long-term survival in patients. In this study, we performed a comparative analysis of the antral wall thickness measured by abdominal computed tomography (CT) with endoscopic and pathological evaluation results. The objective of this study is to determine the optimal cut-off value for wall thickness that can distinguish between benign and malignant conditions, thereby accelerating the diagnostic process in clinical practice and aiding in the determination of appropriate treatment strategies.
Methods: A total of 213 patients who underwent endoscopic antral wall sampling between February 2023 and January 2024, and who had an abdominal CT scan performed within two months before or after the endoscopy were included in this study. The patients’ demographic characteristics, including age and gender, along with antral wall thickness measurements obtained from abdominal CT scans, were retrospectively compared with histopathological results. Furthermore, a cut-off value was determined using ROC analysis for differentiating benign from malignant pathologies, and sensitivity and specificity rates were calculated.
Results: A total of 213 patients were included in the study, comprising 126 males and 87 females, with a mean age of 60.8 years. Among these patients, 94 (60 males, 34 females; mean age 66.1 years) were classified as malignant, while 119 (66 males, 53 females; mean age 56.6 years) were classified as benign (p < 0.001). Using a cut-off value of 12 mm for antral wall thickness to differentiate between benign and malignant conditions, the sensitivity was 100%, and the specificity was 95.7%.
Conclusion: The measurement of antral wall thickness using abdominal CT under optimal conditions provides significant information for differentiating benign and malignant pathologies originating from this region. This measurement plays a critical role in the early diagnosis and treatment of gastric cancer.

Ethical Statement

In this retrospective study, computed tomography images and endoscopic pathology data were used and no retrospective permission was requested from the ethics committee.

References

  • Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(06):394–424
  • Levine MS, Megibow AJ, Kochman ML. Carcinoma of the stomach and duodenum. In: Gore RM, Levine MS (Eds.). Textbook of gastrointestinal radiology. 2nd edition Philadelphia: Saunders Elsevier; 2008: 619-43.
  • Thrumurthy SG, Chaudry MA, Hochhauser D, Mughal M. The diagnosis and management of gastric cancer. BMJ. 2013 Nov 4;347:f6367.
  • Hallinan JT, Venkatesh SK. Gastric carcinoma: imaging diagnosis, staging and assessment of treatment response. Cancer Imaging. 2013 May 30;13(2):212-27.
  • Dixon M, Cardoso R, Tinmouth J, Helyer L, Law C, Swallow C, et al. What studies are appropriate and necessary for staging gastric adenocarcinoma? Results of an international RAND/UCLA expert panel. Gastric Cancer 2014 Apr;17(2):377-82.
  • Coburn N, Seevaratnam R, Paszat L, Helyer L, Law C, Swallow C, et al. Optimal management of gastric cancer: results from an international RAND/UCLA expert panel. Ann Surg 2014 Jan;259(1):102–8
  • Shen Y, Kang HK, Jeong YY, Heo SH, Han SM, Chen K, et al. Evaluation of Early Gastric Cancer at Multidetector CT with Multiplanar Reformation and Virtual Endoscopy. Radiographics 2011 Jan-Feb;31(1):189-99.
  • Akagi T, Shiraishi N, Kitano S. Lymph node metastasis of gastric cancer. Cancers (Basel) 2011 Apr 26;3(2):2141-59.
  • Fawzi SY, Momjian RLB, Khaleel IA. The Role of Spiral Computed Tomography in the Detection & Staging of Gastric Malignancy. IJGE Issue 5 Vol 1 2005
  • Zytoon A, El-Atfey S & Hassanein SH. Diagnosis of gastric cancer by MDCT gastrography: diagnostic characteristics and management potential. Egypt J Radiol Nucl Med 51, 30 (2020).
  • Makino T, Fujiwara Y, Takiguchi S, Tsuboyama T, Kim T, Nushijima Y et al. Preoperative T staging of gastric cancer by multi-detector row computed tomography. Surgery.2011 May;149(5):672–9.
  • Pickhardt PJ, Asher DB. Wall thickening of the gastric antrum as a normal finding: multidetector CT with cadaveric comparison. AJR Am J Roentgenol 2003 Oct;181(4): 973-9.
  • Kul S, Sert B, Sari A, Arslan M, Kosucu P, Ahmetoglu A, et al. Effect of subclinical Helicobacter pylori infection on gastric wall thickness: multislice CT evaluation. Diagn Interv Radiol 2008 Sep;14(3): 138-42.
  • Cho SG, Kim WH, Lee KH, Kim MY, Han H, Ok CS, et al. Wall thickening of the gastric antrum: Is it a pseudolesion or a tumor? J Korean Radiol Soc 1999 Feb;40(2): 281-7.
  • Matzek W, Bastati N, Baroud S, Muin D, Herold C, Ba-Ssalamah A, et al. The Value of HMDCT in Differentiation between Normal and Pathologic Antral Wall Thickening of the Stomach. Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, Nov 28-Dec 3, 2010,Chicago IL.
  • Yavuz A, Akdemir Z, Bora A, Alptekin C, Dülger AC. Abdominal Bilgisayarlı Tomografi Tetkikinde Ölçülen Mide Antropilor Cidar Kalınlığının Benin ve Malin Mide Patolojilerinin Ayırımındaki Etkinliği. Van Tıp Dergisi 2015;22(3): 166-172.
  • Tongdee R, Kongkaw L, Tongdee T. A study of wall thickness of gastric antrum: comparison among normal, benign and malignant gastric conditions on MDCT scan. J Med Assoc Thai. 2012 Nov;95(11):1441-8.
  • Insko EK, Levine MS, Birnbaum BA, Jacobs JE. Benign and malignant lesions of the stomach: evaluation of CT criteria for differentiation. Radiology 2003 Jul;228(1):166-71.
  • Barros RH, Penachim TJ, Martins DL, Andreollo NA, Caserta NM. Multidetector computed tomography in the preoperative staging of gastric adenocarcinoma. Radiol Bras. 2015 Mar-Apr;48(2):74-80.
  • Chen CY, Wu DC, Kang WY, Hsu JS. Staging of gastric cancer with 16-channel MDCT. Abdom Imaging. 2006 Sep-Oct;31(5):514–20. Epub 2006 Feb 7. Erratum in: Abdom Imaging. 2014 Apr; 39(2):440.
  • Balfe DM, Koehler RE, Karstaedt N, Stanley RJ, Sagel SS. Computed tomography of gastric neoplasms. Radiology 1981 Aug; 140(2): 431-6.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Gastroenterology and Hepatology, Radiology and Organ Imaging
Journal Section Research Articles
Authors

Bilge Akhan 0000-0002-4647-7053

Ahmet Karakaya 0000-0002-6638-0005

Bahriye Gültaş 0000-0001-5699-7813

Ferit Yetik 0000-0003-3921-6389

Utku Sağlam This is me 0009-0008-9815-7896

Publication Date October 29, 2025
Submission Date December 21, 2024
Acceptance Date January 27, 2025
Published in Issue Year 2025 Volume: 3 Issue: 3

Cite

EndNote Akhan B, Karakaya A, Gültaş B, Yetik F, Sağlam U (October 1, 2025) Abdominal BT ile Mide Antrumu Duvar Kalınlığının Analizi: Benin ve Malin Patolojileri Ayırt Etmede Yüksek Tanısal Doğruluk. Journal of Bursa Faculty of Medicine 3 3 13–20.

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