Gastric cancer is the 5th most common cancer worldwide and the 3rd leading cause of global cancer mortality, with over 1 million cases diagnosed annually (1). Depending on the stage and location of a gastric cancer, there are multiple surgical options. Each surgery has a different expected postoperative appearance and possible complications.
Educational Goals / Teaching Points
The educational goals of this exhibit include: reviewing appropriate postoperative imaging studies for gastric cancer, when they should be performed, and to describe the expected postoperative appearance after various surgical procedures. Multiple examples, utilizing various modalities including fluoroscopy and CT, will be used to demonstrate the expected postoperative appearance, postoperative complications, and recurrent and metastatic gastric cancer.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The TNM staging system for gastric cancer will be reviewed, with a focus on the influence that each T stage has on the surgical procedure chosen. The expected postoperative appearance of each procedure on fluoroscopy and CT will be reviewed, including the following procedures: Billroth I, Billroth II, total gastectomy, and esophagogastrectomy. The role of lymphadenectomy during surgical resection will be discussed. The imaging appearance of the most common post-operative complications will be shown. Finally, examples of local recurrence and common sites of metastatic disease will be shared.
Gastric cancer is a common cause of morbidity and mortality worldwide. It is essential for radiologists to understand the treatment algorithm and expected postoperative appearance after various surgeries for gastric cancer, as well as to recognize common complications and the appearance of recurrent and metastatic disease.