2026 Volume 64 Issue 5 Pages 801-813
In recent years, amid a growing shortage of physicians responsible for interpreting gastric X-ray examinations, the roles of imaging technologists in identifying abnormal findings and certified interpretation support technologists in appropriately presenting category classifications have become increasingly important. In this article, the process of detecting abnormal findings is organized into four steps: pre-examination preparation, background mucosal assessment, detection of subtle abnormalities, and classification of Category 5. Through concrete examples of category classification, the practical significance of this approach is demonstrated. In background mucosal assessment, evaluating not only the presence or absence of Helicobacter pylori infection but also the degree of mucosal atrophy, intestinal metaplasia, hypertrophic gastritis, and nodular gastritis allows for a more detailed assessment of gastric cancer risk. Particularly in individuals at high risk for gastric cancer, optimization of fluoroscopic observation and imaging techniques can increase sensitivity to subtle abnormal findings, leading to improved accuracy of category classification. Furthermore, certified radiologic technologists for reading assistance play an important bridging role by appropriately identifying candidates for further examination and guiding them toward detailed diagnostic evaluation based on category classification, thereby contributing to improved screening accuracy. These efforts are directly linked to the early detection of gastric cancer and highlight that the technical skills of radiologic technologists have a decisive impact on the quality of gastric cancer screening.
