Gastric Cancer Staging at Multi–Detector Row CT Gastrography: Comparison of Transverse and Volumetric CT Scanning

Kim, Hye Jin; Kim, Ah Young; Oh, Seung Won; Kim, Jung-Sun; Kim, Kyung Won; Kim, Pyo Nyun; Lee, Moon-Gue; Ha, Hyun Kwon

doi:10.1148/radiol.2363041101

Cited by 219 publications

(178 citation statements)

References 28 publications

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“…The reported predictive value for EGC with EGD, MDCT, and EUS were 67.3-92.4% [5,15], 76.5-100.0% [12,13,[16][17][18], 57.1-100.0% [13,[19][20][21][22][23], respectively in various studies. The overall accuracy for EGC of EGD, MDCT and EUS were 83.6-96.8% [5,6,15,24], 77.8-94.1% [12,13,[16][17][18]25], 76.2-95.6% [7,13,[19][20][21][22]26,27], respectively. The values in this study were relatively higher than the results from other studies.…”

Section: Discussionmentioning

confidence: 99%

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

Ahn

Lee

Yoo

et al. 2008

Journal of Surgical Oncology

114

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Background: Preoperative accurate diagnosis of the T and N stages in early gastric cancer (EGC) is important in determining the application of various limited treatments. The aim of this study is to analyze the accuracy of T and N staging of EGC with esophagogastroduodenoscopy (EGD), Stomach protocol CT (S-CT), and endoscopic ultrasonography (EUS), and the factors influencing the accuracy. Methods: Four hundred and thirty-four patients preoperatively diagnosed as EGC using EGD or S-CT and undergoing curative gastrectomy at Seoul National University Hospital in 2005 were included. The T and N stage reviewed by experienced personnel were compared with the surgical pathology. Results:The predictive values for EGC of EGD, S-CT, and EUS were 87.4%, 92.2%, and 94.1%, respectively. The predictive values for node negativity of S-CT, and EUS were 90.1% and 92.6%, respectively. The factors leading to underestimation of T stage with EGD were the upper third location, the size greater than 2 cm, and diffuse type of tumor. Those with S-CT were female sex, the upper third location and lesion size greater than 2 cm. Conclusions: Before applying limited treatment for EGC, a surgeon should consider the risk factors of underestimation of T stage with EGD or S-CT.

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Section: Discussionmentioning

confidence: 99%

“…The T staging criteria of our institution were defined based on the literature (Fig. 1c,d) [10][11][12]. The indication of EGC (T1 lesions) was the presence of gastric wall thickening with enhancement in the inner surface but the preservation of the low-attenuation stripe, corresponding to the submucosal layer, at the base of the lesion.…”

Section: Methodsmentioning

confidence: 99%

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

Ahn

Lee

Yoo

et al. 2008

Journal of Surgical Oncology

114

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“…Eight MDCT studies [14,18,21,22,31,32,35,39] were of high methodological quality. • For the MRI studies, the total methodological quality score ranged from 46% to 77% (median, 62%).…”

Section: Methodological Quality Assessmentmentioning

confidence: 99%

Imaging in assessing lymph node status in gastric cancer

2009

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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%

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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Gastric Cancer Staging at Multi–Detector Row CT Gastrography: Comparison of Transverse and Volumetric CT Scanning

Cited by 219 publications

References 28 publications

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

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

Imaging in assessing lymph node status in gastric cancer

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

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