Essential pre-treatment imaging examinations in patients with endoscopically-diagnosed early gastric cancer

Abstract

BackgroundThere have been no reports discussing which imaging procedures are truly necessary before treatment of endoscopically-diagnosed early gastric cancer (eEGC). The aim of this pilot study was to show which imaging examinations are essential to select indicated treatment or appropriate strategy in patients with eEGC.MethodsIn 140 consecutive patients (95 men, 45 women; age, 66.4 +/- 11.3 years [mean +/- standard deviation], range, 33-90) with eEGC which were diagnosed during two years, the pre-treatment results of ultrasonography (US) and contrast-enhanced computed tomography (CT) of the abdomen, barium enema (BE) and chest radiography (CR) were retrospectively reviewed. Useful findings that might affect indication or strategy were evaluated.ResultsUS demonstrated useful findings in 13 of 140 patients (9.3%): biliary tract stones (n = 11) and other malignant tumors (n = 2). Only one useful finding was demonstrated on CT (pancreatic intraductal papillary mucinous tumor) but not on US (0.7%; 95% confidential interval [CI], 2.1%). BE demonstrated colorectal carcinomas in six patients and polyps in 10 patients, altering treatment strategy (11.4%; 95%CI, 6.1-16.7%). Of these, only two colorectal carcinomas were detected on CT. CR showed three relevant findings (2.1%): pulmonary carcinoma (n = 1) and cardiomegaly (n = 2). Seventy-nine patients (56%) were treated surgically and 56 patients were treated by endoscopic intervention. The remaining five patients received no treatment due to various reasons.ConclusionsUS, BE and CR may be essential as pre-treatment imaging examinations because they occasionally detect findings which affect treatment indication and strategy, although abdominal contrast-enhanced CT rarely provide additional information.

Comparison of Oral Contrast‐Enhanced Transabdominal Ultrasound Imaging With Transverse Contrast‐Enhanced Computed Tomography in Preoperative Tumor Staging of Advanced Gastric Carcinoma

“…cancer at a relatively early stage than at a late stage. 27 Some other studies on this topic reported consistently lower accuracy rates of oral contrast-enhanced US regarding tumor staging. For example, Yu et al, 17 Liu et al, 18 and Li et al 19 reported overall accuracy of oral contrast-enhanced US of 75% to 77%.…”

“…The distinct variability of the accuracy is related to the advances in CT technology and the varied numbers of patients at different tumor stages in different studies . In general, there was lower agreement in tumor staging of gastric cancer at a relatively early stage than at a late stage . Some other studies on this topic reported consistently lower accuracy rates of oral contrast‐enhanced US regarding tumor staging.…”

Integration of Single-Cell and Bulk RNA Sequencing Data using Ecotype Machine Learning for Prognostic Biomarker Discovery in Gastric Cancer

“…As the gold standard for cancer diagnosis, tissue biopsy is often limited by its large trauma to the body and easy dissemination, the inability to achieve dynamic monitoring in a single biopsy, and the limitations of sample collection that cannot reflect heterogeneity [6]. Due to the presence of a certain misdiagnosis rate and limited differential diagnostic value, imaging examinations can often only be used as clinical references [7,8]. Therefore, seeking a non-invasive, minimally invasive, predictive model for early diagnosis and prevention of GC is of great significance.…”