Effectiveness of Standing Compression Radiography in Gastric X-ray Screening

Abstract

 [Background and Objective] In gastric X-ray screening using upright compression, some cases show inadequate compression. This study aimed to identify factors affecting the effectiveness of compression imaging.

 [Subjects and Methods] A total of 800 individuals (400 men and 400 women) who underwent gastric X-ray screening were examined. Cases showing clear radiolucency in all four gastric regions (body, angle, antrum, and prepyloric area) were classified as the effective group, and those without full radiolucency were the ineffective group. Gender, BMI, and gastric morphology were compared between groups. In the effective group, images showing mucosal folds and areae gastricae were defined as high-quality, and the regions most likely to yield such quality were evaluated.

 [Results] The effective group included 344 cases (43%). Women were significantly more frequent in the effective group (68.6%) compared to the ineffective group (36.0%) (p < 0.01). Fewer individuals in the effective group had a BMI ≥ 25 (10.8% vs. 31.4%, p < 0.01). Hook-shaped stomachs were more prevalent in the effective group (93.0% vs. 66.9%, p < 0.01). High-quality images in the effective group were obtained most frequently in the prepyloric area (96.5%), followed by the body (70.1%), angle (45.3%), and antrum (39.5%).

 [Conclusion] Gender, BMI, and gastric shape influence the effectiveness of compression imaging. The prepyloric region, likely due to its anatomical characteristics, yields consistently high image quality. These findings suggest the need to consider individual patient factors and potentially redefine imaging protocols with emphasis on the prepyloric area as a primary target.