CT-Detected Extramural Vessel Invasion and Regional Lymph Node Involvement in Stage T4a Gastric Cancer for Predicting Progression-Free Survival

Cheng, Jin; Feng, Caizhen; Zhang, Yinli; Hong, Nan; Ye, Yingjiang; Wang, Yi

doi:10.2214/ajr.18.20342

Cited by 15 publications

(9 citation statements)

References 26 publications

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“…41,42 However, MRI has great limitation in diagnosing EMVI accurately due to motion artifacts. 43 In this study, ctEMVI was identified as a significant predictor, which agreed with several studies 5,6,44 that had discovered ctEMVI as an independent risk factor for the prognosis of gastric cancer.…”

Section: Discussionsupporting

confidence: 91%

“…3,4 Furthermore, some other characteristics on MDCT, for instance, extramural vessel invasion, have also been proven closely related to the prognosis of gastric cancer. 5,6 However, subjective and qualitative, conventional interpretation of MDCT mainly depends on clinical experience and individual perspective of radiologists. Therefore, novel means should be investigated to accelerate individualized prognostic progress and improve outcomes for gastric cancer patients.…”

Section: Introductionmentioning

confidence: 99%

“…Nowadays, multidetector‐row computed tomography (MDCT) is widely applied in clinical staging owing to its noninvasiveness, convenience, and stability 2 and clinical staging defined on preoperative MDCT has been proven a prognostic indicator of survival 3,4 . Furthermore, some other characteristics on MDCT, for instance, extramural vessel invasion, have also been proven closely related to the prognosis of gastric cancer 5,6 . However, subjective and qualitative, conventional interpretation of MDCT mainly depends on clinical experience and individual perspective of radiologists.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative computed tomography‐guided disease‐free survival prediction in gastric cancer: a multicenter radiomics study

et al. 2020

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Preoperative and noninvasive prognosis evaluation remains challenging for gastric cancer. Novel preoperative prognostic biomarkers should be investigated. This study aimed to develop multidetector-row computed tomography (MDCT)-guided prognostic models to direct follow-up strategy and improve prognosis. Methods: A retrospective dataset of 353 gastric cancer patients were enrolled from two centers and allocated to three cohorts: training cohort (n = 166), internal validation cohort (n = 83), and external validation cohort (n = 104). Quantitative radiomic features were extracted from MDCT images. The least absolute shrinkage and selection operator penalized Cox regression was adopted to construct a radiomic signature. A radiomic nomogram was established by integrating the radiomic signature and significant clinical risk factors. We also built a preoperative tumor-node-metastasis staging model for comparison. All models were evaluated considering the abilities of risk stratification, discrimination, calibration, and clinical use. Results: In the two validation cohorts, the established four-feature radiomic signature showed robust risk stratification power (P = 0.0260 and 0.0003, log-rank test). The radiomic nomogram incorporated radiomic signature, extramural vessel invasion, clinical T stage, and clinical N stage, outperforming all the other models (concordance index = 0.720 and 0.727) with good calibration and decision benefits. Also, the 2-yr disease-free survival (DFS) prediction was most effective (time-dependent area under curve = 0.771 and 0.765). Moreover, subgroup analysis indicated that the radiomic signature was more sensitive in risk stratifying patients with advanced clinical T/N stage. Conclusions: The proposed MDCT-guided radiomic signature was verified as a prognostic factor for gastric cancer. The radiomic nomogram was a noninvasive auxiliary model for preoperative individualized DFS prediction, holding potential in promoting treatment strategy and clinical prognosis.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Preoperative computed tomography‐guided disease‐free survival prediction in gastric cancer: a multicenter radiomics study

et al. 2020

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“…On the contrary, large LN s in StageI/II disease might indicate a favorable outcome. 21,22 In our study, there was not statistically significant difference between metastatic and inflammatory LN s groups for short axis diameters (p > 0.05). But, a previous study showed that the shape of metastatic LN s were more round than inflammatory LN s .…”

Section: Roc Curve Analysis Resultscontrasting

confidence: 58%

Retracted: An application study of CT perfusion imaging in assessing metastatic involvement of perigastric lymph nodes in patients with T1 gastric cancer

Sun

et al. 2019

The British Journal of Radiology

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Objective: To assess metastatic involvement of perigastric lymph nodes (PLNs) in patients with T1 gastric cancer by using CT perfusion imaging (CTPI). Methods: A total of 82 annotated PLNs of 33 patients with T1 gastric cancer confirmed by endoscopic ultrasonography underwent CTPI and portal phase CT scan before operation. The scan data were post-processed to acquire perfusion maps and calculate perfusion parameters including blood flow (BF) and permeability surface (PS). A radiologist measured the short axis diameters and perfusion parameters of PLNs. According to the post-operative pathology result, PLNs were divided into two groups: metastatic and inflammatory LNs. Perfusion parameters values and the size of PLNs between two groups were respectively compared statistically by t-test, and a receiver operating characteristic curve analysis was used to determine the optimal diagnostic cut-off value with sensitivity, specificity and area under the curve. Results: Examined 82 PLNs were metastatic in 45 (54.9%) and inflammatory in 37 (45.1%). The mean values of perfusion parameters and the short axis diameters in metastatic and inflammatory PLNs, respectively, were BF of 97.48 vs 81.21 ml/100 mg /min (p < 0.001), PS of 45.11 vs 36.80 ml/100 mg /min (p < 0.001), and the size of 1.51 cm vs 1.29 cm (p = 0.059). The sensitivity of 84.4%, specificity of 67.6% and area under the curve of 0.826 for BF with cut-off value of 88.89 ml/100 mg /min for differentiating metastatic from inflammatory nodes were higher than those of PS or the size of PLNs (p < 0.001). Conclusion: CT perfusion parameters values were different between metastatic and inflammatory PLNs in T1 gastric cancer. BF value may be the most reliable diagnostic marker of metastatic PLNs, and it is helpful for clinicians to choose treatment modality or management plan in T1 gastric cancer patients. Advances in knowledge: CTPI gives information on vascularization of LNs. BF value might be a more effective marker than PS or the size of LNs for differentiating metastatic from inflammatory LNs in patients with T1 gastric cancer.

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“…Recently, Tan et al proposed some general CT imaging features of EMVI (11), and Kim et al found that EMVI detected by CT was an independent prognostic factor for reduced disease-free survival in patients with gastric cancer (33). Furthermore, in a study by Cheng et al, EMVI detected by CT, combined with N status detected by contrast-enhanced CT, could be used as a valuable preoperative prognostic factor in patients with T4a gastric cancer (34). However, these studies are all based on morphological diagnoses and depend on the experience of the radiologist.…”

Section: Discussionmentioning

confidence: 99%

Value of quantitative dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging in predicting extramural venous invasion in locally advanced gastric cancer and prognostic significance

Zhu¹,

Zhou²,

Zhang³

et al. 2021

Quant Imaging Med Surg

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Background: Extramural venous invasion (EMVI) has been found to be related to poor prognosis in gastric cancer. Preoperative diagnosis of EMVI is challenging, as it can only be detected by surgical pathology. The present study aimed to investigate the value of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) in predicting EMVI preoperatively, and to determine the relationship between prediction results and prognosis in patients with locally advanced gastric cancer (LAGC).

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CT-Detected Extramural Vessel Invasion and Regional Lymph Node Involvement in Stage T4a Gastric Cancer for Predicting Progression-Free Survival

Cited by 15 publications

References 26 publications

Preoperative computed tomography‐guided disease‐free survival prediction in gastric cancer: a multicenter radiomics study

Preoperative computed tomography‐guided disease‐free survival prediction in gastric cancer: a multicenter radiomics study

Retracted: An application study of CT perfusion imaging in assessing metastatic involvement of perigastric lymph nodes in patients with T1 gastric cancer

Value of quantitative dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging in predicting extramural venous invasion in locally advanced gastric cancer and prognostic significance

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