Radiologic diagnosis of early gastric cancer by routine double-contrast examination.

In 4538 double-contrast examinations of the upper gastrointestinal tract, 8 early gastric cancers (EGCs) were prospectively diagnosed before endoscopy. Four others were false negative cases, but retrospective analysis led to identification of the lesion in 3. The rate of EGC in radiologically diagnosed and verified cancers was found to be 10.6%. Gastric polyp rarely corresponded to EGC, whereas gastric ulcer more frequently corresponded to an EGC. Five of 12 EGCs were multifocal, with 21 satellite foci of carcinoma, of which 3 were probably radiologically identifiable as varioliform erosions. Routine double-contrast study appears valuable for detecting EGC, but the rate of false negative cases indicates that integration of radiologic, endoscopic, and cytologic data as well as accurate histopathologic study of the surgical specimen are needed to diagnose and characterize early gastric carcinoma.