Diagnostic Accuracy of Transabdominal Ultrasonography in Evaluation of Gastric Malignancies: A Cross-sectional Study

Abstract

Introduction: Gastric cancer (GC) is the fifth most common malignancy worldwide. Transabdominal Ultrasonography (TA- USG) is a non invasive and inexpensive imaging modality that is widely available. However, there is a lack of knowledge regarding the utility of USG among radiologists in the diagnosis of GC. Aim: To evaluate the accuracy of TA-USG in the detection of gastric malignancy. Materials and Methods: This was a cross-sectional study conducted in the Department of Radiodiagnosis at Father Muller Hospital, Mangaluru, Karnataka, India from October 2021 to February 2023. Patients with Upper Gastrointestinal (UGI) symptoms and suspected Gastric Carcinoma, who underwent UGI scopy (n=107) referred from the Departments of Gastrosurgery, Medical Gastroenterology, and Oncosurgery, were included. The sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of TA-USG in the diagnosis of GC were determined. Results: The TA-USG could diagnose 94 out of 107 cases of malignancy, with the best results in detecting antropyloric malignancy. TA-USG performed worst in early GC. The authors had four cases of early GC, all of which were not diagnosed with TA-USG. The sensitivity, specificity, PPV, NPV, Positive Likelihood Ratio (PLR), Negative Likelihood Ratio (NLR), and accuracy were calculated to be 87.85%, 93.83%, 86.24%, 94.61%, 14.23, 0.13, and 92%, respectively, with a p-value of <0.001. Conclusion: The TA-USG is a valuable tool for detecting gastric malignancy, especially in patients with gastric outlet obstruction, a non distensible stomach, or other risk factors that preclude endoscopy. It can also play a role in regions where UGI endoscopy is not available.