위암의 병변부위의 입체적 정보제공을 위한 Ray-sum 기법의 활용

Application of Ray-sum technique for surgical operation plan of gastric cancer patients

Purpose To Provide the three dimensional image of gastric cancer for pre operation planning of extent of resection margin by Ray-sum technique. Material & Method 34 cases(male 27, female 7) of pathologically proven stomach cancer are included in this examination during Oct. 2004~Jan. 2005. All patients were fasting state during 8 hours, and N injected buscopan 20min, before examination. On the table, they ingested 2 packs of gas forming agent and took the images on the supine position. Imaging examinations were performed with Somatom Sensation 16(Siemens, Erlangen, Germany) CT scanner with 0.75mm collimation, 5mm thickness, 9mm/sec table feed and the images were reconstructed with 1mm thickness and 0.7mm increments. Then we made Ray-sum images by using Wizard (Siemens, Erlangen, Germany) with -400~-1024 threshold, 30% of penetration and 85% brightness. Finally images were analysed by radiologist without knowledge about patients as 4grades(Excellent, Good, Fair, Poor). Result Among 34 cases, early gastric cancer is 17, advanced gastric cancer is 12 and others are 5 cases. 8cases of early gastric cancer and 11 cases of advanced gastric cancer are detected on the Ray-sum images and graded Excellent is 1, Good is 2, Fair is 4 and Poor is 1 case in early gastric cancer and Excellent is 7, Good is 3, Fair is 1 and Poor is 0 case in advanced gastric cancer. As result, the sensitivity of Ray-sum images is 47% of early gastric cancer and 91.6% of advanced gastric cancer. Conclusion CT Ray-sum technique is useful tool for surgical operation plan of gastric cancer patients. And this technique maybe replaced with U.G.I