Stomach Volume Assessment Using Three-dimensional Computed Tomography Gastrography for Bariatric Treatment

Background: Most bariatric treatments employ gastric volume reduction. However, there has been no appropriate tool that could assess the anatomical factors of the stomach, and few studies have investigated proper stomach measurement for bariatric treatment. Thus, this study aimed to objectively estimate the individual stomach using three-dimensional (3D) computed tomography (CT) gastrography for the possible acquisition of information that could facilitate bariatric treatment and to validate these factors. Methods: A total of 100 consecutive patients with different degrees of obesity who underwent 3D CT gastrography were enrolled. Using semiautomatic and manual segmentation tools, 3D volume-rendered images were constructed, and the total volume of the distended stomach, abdominal diameter, and abdominal fat volume (visceral and subcutaneous fat) were measured. Data on patients’ baseline characteristics and laboratory findings were collected. Results: The stomach volume measured using 3D CT gastrography ranged from 268 to 751 mL, whereas the stomach capacity was 572 ± 301.6 mL and 438.5 ± 163.4 mL in patients with body mass index (BMI) ≥ 25 kg/m² and < 25 kg/m², respectively. Visceral fat volume, abdominal circumference, and visceral-to-subcutaneous fat ratio tended to be associated with increased stomach volume. Multivariate analysis showed that BMI and visceral fat volume were significantly associated with stomach volume in female patients. Conclusions: The results of this study indicated the association of stomach volume with obesity status. Objective estimation of the individual stomach presented the possibility of tailored therapeutic approach to obese patients requiring more effective bariatric treatment.