Radiologic diagnosis of gastric cancer. A new outlook

In our monograph we have tried to demonstrate the infeasibility of excluding radiological diagnosis, first and foremost the traditional X-ray examination, from the algorithm for diagnosing gastric cancer. We have produced convincing evidence and explanations for the indispensability of the X-ray, which should be used along with endoscopy. The current morphological and clinical characteristics of gastric cancer suggest that only the combined use of X-ray and endoscopy can change the discouraging situation with regard to relatively early diagnosis of the disease. Radical change is also very difficult without screening. Selective screening may become a reasonable alternative in countries with limited economic potential, Russia included. It is very important to attach greater importance to outpatient services in the attempt to improve the control of the disease. Diagnosis and treatment might thus be radically facilitated. Therefore, the tendency to minimize outpatient use of X-ray examinations works against improving the diagnosis of gastric cancer. All these aspects are discussed in detail in the monograph. Although the main purpose of the monograph is to describe the current role of the X-ray examination in the diagnosis of gastric cancer, the book also covers some problems related to the epidemiology and morphology of the disease in order to disprove the existing underestimation of X-ray potential in early diagnosis. While describing radiological diagnosis, we dwell on its methodological and semeiotic principles, as well as on the special importance of each method. These include the traditional radiological and ultrasonographic methods, computed tomography, and magnetic-resonance imaging. While we value these methods, above all MRI, unlike some other researchers, we rely not only on endoscopy but also on the traditional X-ray, because we believe it greatly increases the objective value of the findings and potentials of each separate method. A special chapter in the monograph is dedicated to our view of the relationship between endoscopy and X-ray in the diagnosis of gastric cancer. The particular value of the clinical findings, which are included in practically all chapters, is their dependability based on surgical and anatomical evidence. We realize that it will be very difficult to change existing views on gastric cancer diagnosis, where priority is given to endoscopy alone. This position is, unfortunately, taken not only by health-care authorities and most clinicians, but also by some leading radiological diagnosticians. All we can do is ask them to read this monograph, which is based on more than 30 years of continuous practical experience. It is our firm conviction that this book can contribute to solving the vitally important problem of diagnosing gastric cancer