Diagnostic accuracy of T and N stages with endoscopy, stomach protocol CT, and endoscopic ultrasonography in early gastric cancer

Ahn, Hye Young; Lee, Hyuk-Joon; Yoo, Moon‐Won; Kim, Sang Gyun; Im, Jong Pil; Kim, Se Hyung; Kim, Woo Ho; Lee, Kuhn Uk; Yang, Han‐Kwang

doi:10.1002/jso.21170

Cited by 116 publications

(102 citation statements)

References 29 publications

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“…Overall TNM staging results for each technique (AUS, CT, MRI, and PET) are presented in Tables 1, 2 [23,24,27,28,34,38,39,47,48,[53][54][55]58], to determine whether the use of more detector rows to capture images translated into better pre-operative staging performances (Table 6). Overall, CT scanners with C4 detectors had significantly better T staging performances compared to CT scanners with \4 detectors.…”

Section: Performance Characteristics Of Pre-operative Imaging Studiesmentioning

confidence: 99%

“…However, detector number did not significantly affect N or M staging performances. We compared the pooled TNM performance characteristics of CT scanners using traditional single plane axial images [25, 28-35, 37, 38, 40-42, 46, 49, 52, 57-59] with scanners using multi-planar reformatted (MPR) images [23,24,27,28,34,38,39,44,47,48,[53][54][55][56]58], to determine whether the addition of multiple image planes translated into better pre-operative staging performances (Table 6). Overall, CT scanners using MPR images had significantly better T staging performances compared to Pre-operative TNM staging S11 Data presented as pooled means ± standard error of all studies within a given category using the inverse variance method.…”

Section: Performance Characteristics Of Pre-operative Imaging Studiesmentioning

confidence: 99%

“…However, exceptions to this trend have been documented. For example, Table 2 shows that Ahn et al [23] had a high overall accuracy of 86.4%, with 88% of the patients staged as T1, while Blackshaw et al [25] had a low overall accuracy of 60%, with 85% of the patients staged as T3/T4. Consistent with the concept of being able to differentiate early versus advanced tumors, the distribution of the patient population can also have an effect on the sensitivity and specificity of identifying lymph nodes.…”

Section: Evaluation Of T Stagingmentioning

confidence: 99%

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How useful is preoperative imaging for tumor, node, metastasis (TNM) staging of gastric cancer? A meta-analysis

et al. 2011

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Background Surgery is the fundamental curative option for gastric cancer patients. Imaging scans are routinely prescribed in an attempt to stage the disease prior to surgery. Consequently, the correlation between radiology exams and pathology is crucial for appropriate treatment planning. Methods Systematic searches were conducted using Medline, Embase, and the Cochrane Central Register of Controlled Trials from January 1, 1998 to December 1, 2009. We calculated the accuracy, overstaging rate, understaging rate, Kappa statistic, sensitivity, and specificity for abdominal ultrasound (AUS), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) with respect to the gold standard (pathology). We also compared the performance of CT by detector number and image type. A meta-analysis was performed. Results For pre-operative T staging MRI scans had better performance accuracy than CT and AUS; CT scanners using C4 detectors and multi-planar reformatted (MPR) images had higher staging performances than scanners with \4 detectors and axial images only. For pre-operative N staging PET had the lowest sensitivity, but the highest specificity among modalities; CT performance did not significantly differ by detector number or addition of MPR images. For pre-operative M staging performance did not significantly differ by modality, detector number, or MPR images. Conclusions The agreement between pre-operative TNM staging by imaging scans and post-operative staging by pathology is not perfect and may affect treatment decisions. Operator dependence and heterogeneity of data may Electronic supplementary material The online version of this article

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Section: Performance Characteristics Of Pre-operative Imaging Studiesmentioning

confidence: 99%

Section: Performance Characteristics Of Pre-operative Imaging Studiesmentioning

confidence: 99%

Section: Evaluation Of T Stagingmentioning

confidence: 99%

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How useful is preoperative imaging for tumor, node, metastasis (TNM) staging of gastric cancer? A meta-analysis

et al. 2011

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“…Strategies range from endoscopic mucosal resection to preoperative neoadjuvant therapy, which is strongly recommended for locally advanced cases (with serosal invasion and/or nodal involvement) [3,4]. Endoscopic ultrasonography (EUS) and multidetector computed tomography (MDCT) are the commonest techniques in the staging of gastric cancer, despite conflicting results having been reported [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Preoperative locoregional staging of gastric cancer: is there a place for magnetic resonance imaging? Prospective comparison with EUS and multidetector computed tomography

et al. 2015

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Background The aim of this study was to prospectively compare the diagnostic performance of magnetic resonance imaging (MRI), multidetector computed tomography (MDCT) and endoscopic ultrasonography (EUS) in the preoperative locoregional staging of gastric cancer. Methods This study had Institutional Review Board approval, and informed consent was obtained from all patients. Fifty-two patients with biopsy-proven gastric cancer underwent preoperative 1.5-T MRI, 64-channel MDCT and EUS. All images were analysed blind, and the results were compared with histopathological findings according to the seventh edition of the TNM classification. After the population had been divided on the basis of the local invasion (T1-3 vs T4a-b) and nodal involvement (N0 vs N?), sensitivity, specificity, positive and negative predictive value, and accuracy were calculated and diagnostic performance measures were assessed using the McNemar test. Results For T staging, EUS showed higher sensitivity (94 %) than MDCT and MRI (65 and 76 %; p = 0.02 and p = 0.08). MDCT and MRI had significantly higher specificity (91 and 89 %) than EUS (60 %) (p = 0.0009 and p = 0.003). Adding MRI to MDCT or EUS did not result in significant differences for sensitivity. For N staging, EUS showed higher sensitivity (92 %) than MRI and MDCT (69 and 73 %; p = 0.01 and p = 0.02). MDCT showed better specificity (81 %) than EUS and MRI (58 and 73 %; p = 0.03 and p = 0.15). Conclusions Our prospective study confirmed the leading role of EUS and MDCT in the staging of gastric cancer and did not prove, at present, the value of the clinical use of MRI.

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“…Endoscopic resection techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have been extensively carried out on selected patients with early gastric tumors and free of lymph node metastasis. However, there are clinical limits for accurate tumor detection and diagnoses using preoperative examinations such as endoscopy, endoscopic ultrasonography (EUS), computed tomography (CT), and positron emission tomography‐computed tomography 2, 3, 4. Carcinoembryonic antigen (CEA) and carbohydrate antigen 19‐9 (CA19‐9) are now commonly used as established serum markers in the clinical management of patients with gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of circulating tumor cells in blood from patients with gastric cancer

Arigami

Uenosono

Yanagita

et al. 2017

Annals of Gastroent Surgery

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Circulating tumor cells (CTC) have been focused on as a target for detecting occult tumors, predicting therapeutic responses and prognoses, and monitoring postoperative recurrence in the clinical management of patients with various malignancies, including gastric cancer. Recent advances in molecular diagnostic tools have contributed to high sensitivity and specificity for the detection of CTC. A conspicuous disparity exists in the incidence of CTC among studies. However, a close relationship has been reported between positivity for CTC and well‐known prognostic clinicopathological factors including depth of tumor invasion, lymph node metastasis, stage, and lymphatic and venous invasion in patients with gastric cancer. According to most studies published on the clinical impact of CTC, the presence of CTC negatively affects the prognosis of patients with gastric cancer. Moreover, the study of CTC based on a meta‐analysis demonstrated their importance as a poor prognostic indicator. In clinical management, pre‐ and post‐therapeutic monitoring of CTC using liquid biopsy may be useful for early detection of subclinical patients or disease recurrence, prediction of tumor progression, and administrative control of adjuvant chemotherapy. Although their functional properties remain unclear, molecular profiling of CTC may contribute to the development of personalized treatment that effectively inhibits tumor progression in patients with advanced gastric cancer. We herein review the clinical significance of CTC as a promising blood marker and therapeutic target in patients with gastric cancer.

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Diagnostic accuracy of T and N stages with endoscopy, stomach protocol CT, and endoscopic ultrasonography in early gastric cancer

Cited by 116 publications

References 29 publications

How useful is preoperative imaging for tumor, node, metastasis (TNM) staging of gastric cancer? A meta-analysis

How useful is preoperative imaging for tumor, node, metastasis (TNM) staging of gastric cancer? A meta-analysis

Preoperative locoregional staging of gastric cancer: is there a place for magnetic resonance imaging? Prospective comparison with EUS and multidetector computed tomography

Clinical significance of circulating tumor cells in blood from patients with gastric cancer

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