Background and Study Aims: Management options for gastric submucosal tumors (SMTs) include tumor removal or
surveillance. If the latter is chosen, it requires repeated measurements of the tumor
diameter. Although this can be achieved using endoscopy or endosonography (EUS), a
less invasive and cheaper method would be welcome. The aim of this prospective study
was to assess the proportion of gastric SMTs that can be visualized using transabdominal
ultrasound of the water-filled stomach.
Patients and Methods: Fifty-one consecutive patients with endosonographically diagnosed gastric SMTs underwent
transabdominal ultrasound examinations of the water-filled stomach performed immediately
after EUS; both procedures were carried out by the same investigator. Transabdominal
ultrasound was considered positive only if: firstly, the tumor was visualized unequivocally;
secondly, its dimensions could be measured; and thirdly, photographic documentation
could be recorded. In each case, a positive result had to be confirmed by an independent
investigator, who reviewed the photographic documentation.
Results: The median size of SMTs on EUS was 25 mm (range 4 - 55 mm). Twelve tumors were located
in the antrum, 25 in the gastric body, and 14 in the gastric fundus or cardia. Transabdominal
ultrasound demonstrated the tumor in 35 of 51 patients (69 %). For tumors ≤ 30 mm,
the visualization rate was 61 % (22 of 36). The location of the tumor and its EUS
features did not significantly affect the sensitivity of transabdominal ultrasound.
Conclusions: In 69 % of patients with endosonographically diagnosed gastric SMTs, the tumor can
also be visualized (and measured) using transabdominal ultrasound of the water-filled
stomach. This noninvasive and inexpensive method may potentially be useful for surveillance
in patients with SMTs, and further evaluation in this setting is warranted.
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M. Polkowski, M.D.
Dept. of Gastroenterology, Medical Centre for Postgraduate Education · Institute of
Oncology
Roentgena 5 · 02-781 Warsaw · Poland
Fax: + 48-22-644-7601
Email: polek@coi.waw.pl
