Peritoneal Metastasis: Detection with 16– or 64–Detector Row CT in Patients Undergoing Surgery for Gastric Cancer

Kim, Su Jin; Kim, Hyung‐Ho; Kim, Young Hoon; Hwang, Sun-Hwi; Lee, Hye Seung; Park, Do Joong; Kim, So Yeon; Lee, Kyung Ho

doi:10.1148/radiol.2532082272

Cited by 124 publications

(105 citation statements)

References 29 publications

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“…Pathologic staging of gastric carcinoma using T (tumor), N (node), and M (metastases) system (AJCC) [7] nodes. AGCs can develop peritoneal metastases which are correlated with tumor size and T staging [36]. The pre-operative diagnosis of peritoneal carcinomatosis is important to prevent unnecessary open surgery.…”

Section: Stagingmentioning

confidence: 99%

Gastric cancer: Imaging and staging with MDCT based on the 7th AJCC guidelines

et al. 2011

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Gastric cancer is a common deadly cancer worldwide. The tumor-node-metastasis (TNM) staging system is one of the most commonly used staging systems, and is accepted and maintained by the International Union against Cancer (UICC) and the American Joint Committee on Cancer (AJCC). The TNM system is well known to effectively predict the prognosis of gastric cancer patients. The latest revision of TNM staging was presented in the 7th edition of the AJCC in 2009. Multi-detector row CT (MDCT) is a powerful test for non-invasive evaluation and can assess metastatic and locoregional staging simultaneously. Current MDCT with isotropic imaging and 3D images has increased the accuracy of T and N staging in patients with gastric cancer. Multi-planar reformatted images permit the radiologist to select the optimal imaging plane to accurately evaluate tumor invasion depth of the gastric wall and perigastric infiltration to identify a fat plane between a tumor and adjacent organs, to avoid partial volume averaging effects, and to differentiate lymph nodes from small perigastric vessels. Thus, MDCT provides a useful all-in-one diagnostic method for the pre-operative evaluation of patients with known, or strongly suspected, gastric cancer according to the 7th AJCC TNM staging system.

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Section: Stagingmentioning

confidence: 99%

Gastric cancer: Imaging and staging with MDCT based on the 7th AJCC guidelines

et al. 2011

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“…Conventional whole-body imaging technologies such as computed tomography (CT) and magnetic resonance imaging (MRI) are powerful modalities for detecting metastases in solid organs such as liver, lung, bone, and lymph nodes and monitoring their recurrence. However, peritoneal metastases at an early stage consist of small flat lesions less than 1 cm in diameter on the surface of the peritoneal cavity, and they are difficult to diagnose by conventional CT/MRI [3]. Molecular imaging using labeled small-molecule tyrosine kinase inhibitors, peptides, and antibodies as molecular probes are potential alternatives for conventional image diagnostics [4], including positron emission tomography (PET), single photon emission computed tomography (SPECT), molecular MRI, and optical imaging [5,6].…”

Section: Introductionmentioning

confidence: 99%

New whole-body multimodality imaging of gastric cancer peritoneal metastasis combining fluorescence imaging with ICG-labeled antibody and MRI in mice

Ito¹,

Ito²,

Matsushima³

et al. 2013

Gastric Cancer

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Background Peritoneal metastasis is the most frequent pattern of recurrence after curative surgery for gastric cancer. However, such a recurrence is difficult to detect by conventional computed tomography (CT) and magnetic resonance imaging (MRI) at an early stage. To improve the sensitivity and specificity of diagnostic imaging for peritoneal metastasis, we developed a new type of multimodality imaging combining fluorescence imaging with nearinfrared fluorophore (NIR)-labeled antibodies and MRI. Methods Dual optical imaging of peritoneal metastasis was carried out using luciferase-tagged gastric cancer cell lines and XenoLight CF750 or indocyanine green (ICG)-labeled anti-human epidermal growth factor receptor (EGFR) or CEA antibody as a probe in mice with Ivis in vivo imaging system.Results This whole-body fluorescent imaging system sensitively detected metastatic foci \1 mm in diameter in the peritoneal cavity noninvasively. Fluorescence imaging proved to be specific because the fluorescence signal was abolished by blocking with excess unlabeled antibody. Although this fluorescence imaging had higher sensitivity for detection of small-sized peritoneal metastases than MRI, it proved difficult to accurately determine organ distribution of the metastasis. We thus developed a multimodality imaging system by the fusion of the threedimensional fluorescence image with the MRI image and demonstrated its improved diagnostic accuracy over either method alone. Conclusion The present results suggest that multimodality imaging consisting of fluorescence imaging with NIRlabeled EGFR or CEA antibody and MRI allows sensitive, specific, and anatomically accurate detection of peritoneal metastasis noninvasively at an early stage.

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“…MDCT represents the more versatile diagnostic method in evaluating peritoneal disease due to its wide availability, rapid execution time, absence of misregistration artifacts, and the possibility of acquiring thin sections to obtain MPR images covering a large volume of tissue [6] and detecting subcentimetric implants. Using an adequate diagnostic technique (both section thickness and reconstruction interval of 3 mm), the reported mean sensitivity for detecting implants 5 mm is 89 %, with a specificity of 92 % [7].…”

Section: Advantages Of Computed Tomographymentioning

confidence: 99%

“…In the literature, overall sensitivity and specificity of contrast-enhanced (CE) MDCT in identifying peritoneal deposits vary substantially, ranging from 25 % to 93 % [6,16] and from 78 % to 98 %, respectively [6,17]. The reason for this wide variability is multifactorial, including differences in tumor characteristics (size or density), patient features (CT assessment of peritoneal metastases is more difficult in very thin patients), radiologist expertise, diagnostic criteria used in CT interpretation, and CT techniques.…”

Section: Disadvantages Of Computed Tomographymentioning

confidence: 99%

“…Even using an advanced CT technique, for small peritoneal nodules, detection rate for peritoneal metastases is not greatly improved. In particular, when malignant peritoneal deposits have a low volume (< 5 mm), reported CT sensitivity tends to decrease [6,18]. Marin et al, using a 64-row CT scanner with a more accurate technique (effective section thickness and reconstruction interval 3 mm), assessed preoperatively PC in 18 patients with different neoplasm types.…”

Section: Disadvantages Of Computed Tomographymentioning

confidence: 99%

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