Diagnostic performance of 64-MDCT and 1.5-T MRI with highresolution sequences in the T staging of gastric cancer: a comparative analysis with histopathology

Anzidei, Michele; Napoli, Alessandro; Zaccagna, Fulvio; Paolo, Pier Luigi Di; Zini, Chiara; Marincola, Beatrice Cavallo; Geiger, Daniel; Catalano, Carlo; Passariello, Roberto

doi:10.1007/s11547-009-0455-x

Cited by 39 publications

(40 citation statements)

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“…The literature yields accuracy values ranging from 69 to 89 % for MDCT and from 73.5 to 87.5 % for MRI along with an accuracy of 76.7 % for EUS and 78.2 % for MDCT, respectively, without significant differences [16,33]. In our study EUS showed the highest sensitivity, underlining the primary role of this technique in the detection of locally advanced tumours and, thus, its capability to correctly recommend neoadjuvant therapy instead of immediate surgical resection.…”

Section: Discussionmentioning

confidence: 99%

“…breath-hold sequences and diffusion-weighted imaging (DWI)] have improved the value of MRI for abdominal imaging, including imaging of gastric cancer [16]; in particular, on DWI pathological tissue is characterized by higher signal intensity than normal structures [17]. MRI studies report an accuracy ranging from 73.5 to 87.5 % for T stage [18,19] and from 55.2 to 65 % for N stage [19,20].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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“…The few studies that exist mostly compare multislice CT with MRI. These studies did not show a substantial benefit of one over the other method (Anzidei et al 2009;Wang et al 2000). The same was found for the staging of regional lymph nodes.…”

Section: Mrimentioning

confidence: 51%

Clinical Staging of Adenocarcinoma of the Esophagogastric Junction

Cordin¹,

Lehmann²,

Schneider

2009

Adenocarcinoma of the Esophagogastric Junction

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Tumors of the esophagogastric junction are among the most frequent and cause lethal cancers. Patients often do not present until late in the disease when the tumor is sufficiently large to cause obstruction or invasion of the adjacent structures, and thus becomes symptomatic. Preoperative staging is critical to select those patients whose disease is still locally confined for curative surgery. Ideally, clinical staging should accurately predict tumor invasion, lymph node involvement, and distant metastases. Upper endoscopy establishes the tumor diagnosis by multiple biopsies and defines the tumor type (Siewert I-III), based on tumor localization in relation to the endoscopic cardia. Preoperative TNM staging has a strong impact on treatment strategy. Endoscopic Ultrasound (EUS) determines the T category, and to a lesser extent, the presence of lymph node metastases. Multislice Computed Tomography (CT) and 18Fluorode-ocx-glucose Positron Emission Computed Tomography (18FDG-PET-CT) provide further information, especially about systemic metastases. Diagnostic laparascopy is suggested in advanced (CT3/4) Siewert type II-III tumors to exclude peritoneal carcinomatosis. This chapter summarizes current staging modalities and their accuracy in clinical practice.

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“…We compared the pooled T (T3-4 vs T1-2) performance characteristics of MRI with DWI 9,22,24,25 to those without DWI 23,[26][27][28][29][30] to determine whether DWI could have helped preoperative staging performances (Table 4). However, we found that the summary results for T staging of GC (Table 4) showed no statistically significant difference between MRI with DWI and without DWI in sensitivity (p 5 0.279) and specificity (p 5 0.283).…”

Section: Subgroup Analysesmentioning

confidence: 99%

The utility of MRI for pre-operative T and N staging of gastric carcinoma: a systematic review and meta-analysis

Huang¹,

Xie²,

Guo³

et al. 2015

BJR

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Objective: To perform a meta-analysis and literature review regarding the diagnostic accuracy of MRI for pre-operative tumour depth invasion (T) and regional lymph node invasion (N) staging of gastric carcinoma (GC). Methods: Articles were identified through systematic search of Medline, PubMed, Cochrane Library, Web of Science, Springerlink and several Chinese databases. The study quality was assessed by the quality assessment for studies of diagnostic accuracy. 2 reviewers independently extracted and assessed the data from 11 eligible studies. A meta-analysis was then carried out. Subgroup and sensitivity analyses were also performed. Results: 11 studies (439 patients) were finally included in the current review. Among these studies, the significant evidence of heterogeneity was only discovered for Subgroup analyses showed that diffusion-weighted imaging was more helpful for T staging. Conclusion:The present systematic review suggests that MRI has a good diagnostic accuracy for pre-operative T staging of GC and should be widely used in clinical work. However, the ability for N staging is relatively poor on MRI. Advances in knowledge:In the pre-operative staging of GC, MRI was a useful tool and may enhance accuracy for the T staging of advanced GC.Gastric carcinoma (GC) is the fourth most common cancer and the second leading cause of cancer-related death with a 5-year survival rate of ,20% around the world. 1 The disease is more common in Asian countries, especially China, Japan and Republic of Korea.2,3 Accurate assessment of local tumour depth invasion (T) and regional lymph node invasion (N) plays an essential role in predicting prognosis and determining the most appropriate treatment planning. 4,5The pre-operative staging of GC has been based on a multimodality approach, such as endoscopic ultrasonography (EUS), CT, MRI and positron emission tomography (PET).6,7 EUS and CT have been widely used for GC staging in previous years.8 Of course, different imaging modalities have themselves relative merits. CT with ionized radiation requires the injection of iodine contrast medium.9 EUS is an invasive technique requiring sedation 1 and is highly operator dependent.10 PET highly depends upon the standardized uptake value and the pathological subtype of the cancer. 11MRI is a powerful imaging method with high soft-tissue contrast, with technical versatility for sequence selection and modification, and without ionizing radiation. However, it was unsuitable for the staging of GC owing to its long acquisition time and susceptibility to motion artefacts in previous years. With technology improved and shorter imaging time, these limitations have recently been partially overcome. 12Recently, there has been much research using MRI to assess pre-operative staging of GC. Nevertheless, the number of patients in each study has been insufficient, and the results varied among the articles. Also, the limited imaging field of view of MRI in a single session makes it difficult to stage the distant metastasis (M). 13Therefore, the o...

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Diagnostic performance of 64-MDCT and 1.5-T MRI with highresolution sequences in the T staging of gastric cancer: a comparative analysis with histopathology

Abstract: MR imaging and 64-MDCT accuracy levels did not differ in advanced stages of disease, whereas MR imaging was superior in identifying early stages of gastric cancer and can be considered a valid alternative to MDCT in clinical practice.

Cited by 39 publications

References 36 publications

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

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

Clinical Staging of Adenocarcinoma of the Esophagogastric Junction

The utility of MRI for pre-operative T and N staging of gastric carcinoma: a systematic review and meta-analysis

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