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Ultrasound is a common diagnostic technique today and is meaningful in screening, detecting, diagnosing as well as monitoring and treating many different diseases, including cancer. Can ultrasound detect stomach cancer?
1. What is ultrasound?
Ultrasound is a widely used laboratory method in medicine. Ultrasound applies the characteristics of ultrasound waves - high-frequency sound waves to survey organs in the digestive system, cardiovascular system, obstetrics and gynecology, mammary gland, thyroid gland,... through reconstructed images. about the internal structure of the body, thereby helping doctors detect many different medical conditions.
The radiologist will use an ultrasound transducer that both transmits ultrasound waves and receives signals. After applying a gel to the skin outside the organ to be examined (this gel helps to improve image quality in ultrasound), the doctor will bring the ultrasound probe close to the patient's skin and scan the probe to Explore the internal organs. The image obtained from the ultrasound probe will be broadcast directly to the screen to help the doctor detect abnormal medical conditions.
Currently, there are many ultrasound techniques and its applications have been deployed to increase diagnostic efficiency:
2D ultrasound (2D ultrasound): The most popular ultrasound method today. 3D ultrasound (3-dimensional ultrasound), 4D ultrasound (3-dimensional ultrasound in real time): More and more deployed, often applied in fetal ultrasound. Doppler ultrasound: To examine the heart and blood vessels. Elastic ultrasound: Assess the stiffness and stiffness of the liver, thyroid, mammary glands... Ultrasound through the transvaginal transducer: Helps to survey more accurately for obstetric and gynecological diseases. Endoscopic ultrasound: A modern method that combines two techniques of endoscopy and ultrasound. Endoscopic ultrasound uses an endoscope with an ultrasound probe to help diagnose and intervene in the gastrointestinal tract (esophagus, stomach, colon), liver, bile, pancreas or other lesions. parenteral route, with minimal invasiveness. This technique is especially meaningful in early detection and diagnosis of gastrointestinal cancers such as stomach, or tumors located deep in the abdomen. Biopsy of suspected lesions under ultrasound guidance: Besides diagnosis, ultrasound also supports other techniques such as fine needle aspiration (FNA) or biopsy of lesions of unknown nature below. guided by ultrasound, pleural puncture under the guidance of ultrasound, ... With the development of modern medicine more and more new equipment and techniques are applied, ultrasound still proves to be effective. its role with many advantages: Simple, fast, easy to implement, painless, non-invasive, less toxic and reasonable price.
2. Can ultrasound detect stomach cancer?
Stomach cancer is quite common in the world with different incidence rates in each region, of which Japan and China are the countries with the highest incidence rates in the world. In the US each year, about 26,240 new cases are recorded and the number of patients dying from stomach cancer is up to 10,800 cases per year. The incidence of gastric cancer increases with age with more than 75% of gastric cancer patients aged 50 years or older.
The early detection of gastric cancer is of great significance so that it can be treated promptly to reduce the rate of recurrence, distant metastasis as well as reduce mortality.
A question many people are interested in is whether abdominal ultrasound can detect stomach cancer or not? It is necessary to confirm that ultrasound is not a test that can definitively diagnose stomach cancer, early detection of stomach cancer thanks to ultrasound also seems to be more difficult because the stomach is a hollow organ, so ultrasound is difficult to detect. present small, newly formed lesions. However, ultrasound still has certain values for gastric cancer:
Transabdominal ultrasound can help detect gastric lesions, especially when the tumor is too large with suggestive features malignant disease. The detection of suspected lesions through ultrasound is the reason for the doctor to order other necessary tests such as endoscopy, biopsy to confirm the diagnosis of stomach cancer. Ultrasonography also helps to assess whether or not regional lymph nodes are suspected to be secondary, or detect distant metastases, in patients who have been diagnosed or suspected to have gastric cancer. Ultrasound also helps to quickly diagnose complications of stomach cancer such as intestinal obstruction, semi-obstruction, .... Endoscopic ultrasound: If ultrasound does not show much value in detecting stomach cancer. endoscopic ultrasound has great significance in evaluating gastric cancer in situ, in the region, especially when the tumor is at an early stage. Endoscopic ultrasound proves to be superior to other methods when the ultrasound image of gastric cancer allows to accurately determine the extent of invasion of the primary gastric tumor through the layers of the stomach wall, the degree of invasion to surrounding organs, as well as assess the status of nearby lymph node metastasis.
3. How to detect stomach cancer early?
Early diagnosis of stomach cancer poses a challenge as symptoms at this stage are often very poor. Therefore, gastric cancer screening is very meaningful for early detection and timely treatment.
Gastroscopy combined with biopsy of suspected lesions is considered the "core" method for definitive diagnosis of gastric cancer. In addition, a number of other tests also contribute to the diagnosis.
3.1. Gastroscopy combined with biopsy for pathology The development of medicine has produced many lines of endoscopes with increasingly advanced and modern features for the diagnosis of gastric cancer.
Normal light endoscopy: It is a popular endoscope in Vietnam with an accuracy of up to 90-96%. Gastroscopy allows to detect abnormal lesions in the stomach, in which it is possible to encounter suspected cancerous lesions such as warts, ulcers, change in mucosal color,... Stomach lesions Suspect will be biopsied and sent to the Department of Pathology for histopathology to confirm the diagnosis. Endoscopic staining: Gastric adenocarcinoma usually develops on the background of epithelial cells with chronic inflammatory lesions. Early gastric cancer lesions can be missed by confusion with benign mucosal areas. The endoscopic staining method allows the detection of dysplastic mucosa by irregular coloration, thereby orienting the biopsy site and making an accurate diagnosis. Magnified endoscopy and staining can be combined to magnify and highlight indistinct malignant, dysplastic lesions in the gastric mucosa. 3.2. Endoscopic gastric ultrasound As mentioned above, endoscopic gastric ultrasound has great significance in assessing gastric cancer lesions in situ, in the area, helping to accurately diagnose the stage of the disease.
The gastroscope is fitted with an ultrasound probe that allows access to the nearest gastric tumor, without the limitations of conventional transabdominal ultrasound such as image noise, gas entrapment. Endoscopic ultrasound helps to distinguish lesions in the gastrointestinal tract wall or from the outside; assess the size, structure, invasiveness of gastric tumors with high accuracy.
3.3. Other test techniques in the diagnosis of stomach cancer
Abdominal ultrasound: Ultrasound can detect large stomach tumors, in addition, ultrasound also shows abnormal abdominal lymph nodes or other organs suspicious. suspected distant metastases such as liver, peritoneal, pleural metastases,... Ultrasound also helps in differential diagnosis of gastric cancer with some other conditions. Abdominal X-ray, X-ray with baryte contrast: can detect gastric stenosis due to gastric tumor or injury from outside the gastrointestinal tract. Whole-body computed tomography: Computed tomography of the abdomen combined with endoscopic ultrasound helps to accurately assess gastric cancer lesions in situ, in the region. Whole-body computed tomography helps to screen for secondary systemic lesions, thereby assessing the stage of the disease. PET/CT: PET/CT proves to be superior to CT in detecting small lesions, helping to detect gastric cancer early as well as secondary systemic lesions. These methods complement gastroscopy, biopsy, and pathology. However, it should be emphasized that the definitive diagnosis of gastric cancer is still based on histopathological findings.
In summary, ultrasound is a test that contributes to the diagnosis and monitoring of gastric cancer. However, ultrasound does not give an accurate result whether a patient has gastric cancer and the value of ultrasound in early detection of gastric cancer seems to be very low. Gastric cancer is only evident for large stomach tumors or enlarged abdominal lymph nodes. Ultrasound does not help in early detection of stomach cancer, but it is considered a paraclinical method as a premise for doctors to have a basis for implementing other methods and techniques to accurately detect cancer. Gastroscopy and biopsy of suspected lesions for pathology are considered to be the definitive diagnostic criteria for gastric cancer. In addition, gastroscopy combined with ultrasound is a new technique that is increasingly valuable in evaluating local and regional lesions of gastric cancer.
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