9
Summary
In our monograph we have tried to demonstrate the infeasibility of excluding radiological diag- nosis, first and foremost the traditional X-ray ex- amination, from the algorithm for diagnosing gastric cancer. We have produced convincing ev- idence and explanations for the indispensability of the X-ray, which should be used along with en- doscopy.
The current morphological and clinical char- acteristics of gastric cancer suggest that only the combined use of X-ray and endoscopy can change the discouraging situation with regard to relative- ly 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. Di- agnosis and treatment might thus be radically fa- cilitated. Therefore, the tendency to minimize outpatient use of X-ray examinations works against improving the diagnosis of gastric can- cer. 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 examina-
tion in the diagnosis of gastric cancer, the book al- so covers some problems related to the epidemiolo- gy 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 prin- ciples, as well as on the special importance of each method. These include the traditional radiologi- cal and ultrasonographic methods, computed to- mography, and magnetic-resonance imaging.
While we value these methods, above all MRI, un- like some other researchers, we rely not only on endoscopy but also on the traditional X-ray, be- cause we believe it greatly increases the objective value of the findings and potentials of each sep- arate method.
A special chapter in the monograph is dedi- cated to our view of the relationship between en- doscopy and X-ray in the diagnosis of gastric can- cer. The particular value of the clinical findings, which are included in practically all chapters, is their dependability based on surgical and ana- tomical evidence.
We realize that it will be very difficult to
change existing views on gastric cancer diagno-
sis, where priority is given to endoscopy alone.
296 Chapter 9 · Summary
