Abdominal Imaging 25:1-6 (2000)
Lee D.H.
In the evaluation of gastric disease, upper gastrointestinal series (UGIS) and gastroscopy have been used for the detection of gastric abnormality. Computed tomography (CT) has been proved to be a valuable tool in addition to UGIS and gastroscopy in the evaluation of gastric disease [1, 2]. Spiral CT has been used for not only detection of gastric abnormality but also staging of gastric tumor. Two-dimensional imaging using a multiplanar reconstruction (MPR) algorithm may be helpful for the accurate staging of gastric tumors.
Three-dimensional (3D) spiral CT has been used to visualize the vascular system. Currently, 3D CT is used for gastrointestinal tract imaging [3, 4]. Gastric tumors may be evaluated by using 3D reconstruction images based on the shaded surface display (SSD) technique [5-10]. There are two 3D reconstruction algorithms for the evaluation of the stomach. One is 3D CT, and the other is virtual gastroscopy. Three-dimensional CT images correspond to UGIS findings, and virtual gastroscopic images correspond to real gastroscopic findings. Thus, 3D CT depicts images from the viewpoint of the surgeon, and virtual gastroscopy provides endoscopic images from the viewpoint of the internist. Surgeons prefer 3D CT images to virtual gastroscopic images. Software packages have been designed specifically for virtual endoscopic images: Fly on the Prominence workstation by Siemens, Navigator on the Advantage Windows workstation by General Electric, and Voyager on the Voxel Q workstation by Picker [11]. The effects of these software packages are not very different. The current status of 3D CT and virtual gastroscopic images are primitive, and further technical developments are necessary to obtain better 3D CT and virtual gastroscopic images.
This article describes the spectrum of clinical applications of 3D CT and virtual gastroscopy for imaging gastric lesions.