What Additional Radiography is Useful in Gastric X-ray Screening?

Abstract

 Radiographers engaged in gastrointestinal radiographic screening must first learn the standard radiographic method and the new guideline radiographic method for the detection of life-saving gastric cancer. Guideline radiography uses high-concentration, low-viscosity powdered barium powder and mainly employs double contrast radiography, taking images of the posterior wall, anterior wall, and upper part of the stomach in that order. The radiographer occasionally takes additional radiography at his or her discretion during the examination. Additional radiography have the following three meanings. (1) Images that are identified as abnormal but that can be determined to have no deviation from the normal mucosa by subsequent fluoroscopic observation and imaging, (2) Images to compensate for insufficiently delineated areas in screening, and (3) Images to delineate the extent of the mucosa in detail when the findings identified as abnormal are deviated from the normal mucosa. In the present study, we defined an additional as an image that depicts how far away from the normal mucosa is without interfering with the guideline radiographic technique, and evaluated its validity.

 As a result, there was a case in which an abnormal finding was recognized by fluoroscopic observation but interfered with the guideline imaging technique, affecting the subsequent screening imaging. On the other hand, there were cases in which the patient had the fluoroscopic skills and imaging techniques to perform additional imaging, but did not have the morphology to obtain the gross and visual characteristics of gastric cancer, such as the basis for diagnosis and information that takes into account treatment.

 In order to obtain effective additional radiography for gastric radiographic screening, it is necessary to be able to construct radiographic techniques based on guideline radiography, and to apply the knowledge obtained from academic conferences and case review meetings to radiographic imaging. It was thought that this was a shortcut to learning effective additional radiography.