2026 Volume 64 Issue 5 Pages 786-800
Background and Objective:
Additional radiography imaging in gastric cancer screening using X-ray can be broadly classified into two categories: imaging performed when the gastric mucosal region cannot be adequately visualized within the prescribed imaging positions and number of images, and imaging performed to improve the reproducibility of abnormal findings. The purpose of such imaging is to achieve both accurate lesion depiction and comprehensive evaluation. However, the specific techniques and imaging methods depend largely on the experience and knowledge of the operator, and variability in technical skill remains a recognized issue. In this article, we aimed to clarify the techniques and necessity of additional radiography imaging according to gastric morphology and examination conditions, as well as the criteria for determining when additional radiography imaging is required.
Subjects and Methods:
The subjects included cases requiring additional radiography imaging due to gastric morphological conditions such as cascade stomach, steer-horn stomach, and flexion of the posterior wall of the antrum, as well as cases with abnormal fold formation in the greater curvature and difficulty in imaging the anterior wall. Furthermore, the usefulness of additional radiography imaging for qualitative diagnosis in cases with abnormal findings was described through case studies.
Results and Conclusion:
In cases requiring additional radiography imaging, imaging techniques combining positional changes, appropriate selection of imaging positions, compression methods, respiratory control, and adjustment of barium volume were essential. In addition, case-by-case management of barium outflow, insufficient or excessive air volume, and blind areas was required. Appropriate implementation of these techniques led to improved diagnostic accuracy.
