Introduction Computed Tomography (CT) is often an initial investigation when investigating someone for malignancy. Other malignancies can be identified via incidental findings from other modalities such as Magnetic Resonance Imaging (MRI) or Barium studies. There is anecdotally a perception that CT is not reliable in the diagnosis of upper gastrointestinal malignancies. Despite this, when there are findings suggestive of malignancy such as thickening of gastric tissue, an OGD is indicated.
Method We analysed all OGDs performed in Epsom & St Helier NHS Trust from February 2016 to February 2017 due to abnormal radiology. We searched for these using the Endoscopy program HICSS database.
Results We identified 30 OGDs performed in the above period. Initial indications for imaging included dysphagia (8 patients), weight loss and anaemia (4 patients), abdominal pain (1 patient), raised ALP (2 patients), staging CT for other malignancies (6 patients), imaging for another disorder (1 patient), haemetemesis or malaena (3 patients), evaluation of obstructive lung disease (1 patient), duplication cyst on Barium swallow (1 patient), MRI for spinal disease (1 patient), and decompensated liver disease surveillance for malignancy (2 patients).
After OGD, 5 new malignancies were identified (2 known malignancies) (Positive Predictive Value of 16.67%, 95% CI 13.16% to 20.88%) with 7 OGDs showing no abnormality, 6 showing oesophagitis or a hiatus hernia, 2 with food residue, 2 benign polyps, 2 ulcers, 2 benign strictures, 1 oesophageal candidiasis and 1 Barrett’s oesophagus.
Conclusion The above results confirm that OGDs completed due to suspicious imaging (mainly CT) are appropriately performed and are able to diagnose a significant amount of upper gastrointestinal malignancies.
Disclosure of Interest None Declared
- computed tomography
- Upper Gastrointestinal Cancer