Preoperative assessment of gastric carcinoma: value of two-phase dynamic CT with mechanical iv. injection of contrast material.

Cho, June-Sik; Kim, Jong-Kun; Rho, Seung-Moo; Lee, Heon-Young; Jeong, Hyun-Yong; Lee, Choong-Sik

doi:10.2214/ajr.163.1.8010251

Cited by 111 publications

(53 citation statements)

References 14 publications

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“…According to previous reports where investigators used a single-detector helical CT scanner, the detection rate of early gastric cancers on twodimensional axial CT was low, between 26% and 56% [16][17][18]. Our detection rate for early gastric cancers is similar to the results obtained by the use of a singledetector helical CT [16][17][18].…”

Section: Discussionsupporting

confidence: 85%

Comparison between blinded and partially blinded detection of gastric cancer with multidetector CT using surgery and endoscopic submucosal dissection as reference standards

Kim

Lee²,

Ko³

2010

BJR

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ABSTRACT. The aim of this study is to compare blinded with partially blinded detection of gastric cancer with multidetector (MD) CT by using surgery and endoscopic submucosal dissection (ESD) as reference standards. 44 patients with gastric cancer underwent MDCT with air as an oral contrast agent. Surgery was performed on 37 patients, ESD on six and surgery after ESD on one. To provide comparison cases of blinded evaluation, 38 MDCT examinations were added for cases where no focal gastric lesion was seen on endoscopy. Two radiologists, blinded to the presence, number and location of the tumours, evaluated axial and axial plus multiplanar reformation (MPR) images of 82 MDCT examinations with or without gastric cancer. For partially blinded evaluation, the same radiologists, blinded to the location and number of tumours, evaluated axial and axial plus MPR images of 44 MDCT examinations of gastric cancer. Differences in assessment were resolved by consensus. 45 gastric cancers were found in surgical and ESD specimens. Detection rates of gastric cancer from axial and axial plus MPR images during blinded evaluation and from axial and axial plus MPR images during partially blinded evaluation were 62% (28/45), 64% (29/45), 64% (29/45) and 71% (32/45), respectively. There was no statistical significance for the comparison between blinded and partially blinded detection rates of gastric cancer. The detection rate of gastric cancer with MDCT during blinded evaluation showed no specific difference compared with the detection rate of gastric cancer with MDCT during partially blinded evaluation. . However, patients with early gastric cancer have 5-year survival rates of more than 85% [3,4]. Therefore, early detection of gastric cancer is essential for the improvement of patient survival and for the reduction of the overall use of medical resources. Although the use of endoscopy and a double-contrast barium study has a significant role in the detection of gastric cancer, the depth of tumour invasion and the presence or absence of metastasis cannot be determined by the use of these modalities. Multidetector CT (MDCT) is usually performed for pre-operative staging work-up of patients with gastric cancer. Accurate evaluation of the location and local extent of the gastric cancer (T stage) is important in the choice of the optimal therapeutic approach. However, if gastric cancer cannot be detected on MDCT, the modality cannot provide the information about the location and T stage of gastric cancer. Thus, lesion detection on MDCT is a prerequisite for gastric cancer staging on MDCT [5].Currently, some early gastric cancers may be treated with laparoscopic gastrectomy or endoscopic submucosal dissection (ESD) without laparotomy [6,7]. However, most studies on gastric cancer have confined the study population to patients who have received a laparotomy [5,[8][9][10][11]. This strict confinement of the study population may result in an overestimation of the detection rate of gastric cancer. Most results for the detection rate of gastr...

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Section: Discussionsupporting

confidence: 85%

Comparison between blinded and partially blinded detection of gastric cancer with multidetector CT using surgery and endoscopic submucosal dissection as reference standards

Kim

Lee²,

Ko³

2010

BJR

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“…Furthermore, the limited spatial resolution often misses tiny metastases [1] . Cho JS suggested that dynamic CT be used to improve the diagnostic accuracy in the preoperative staging of gastric cancer [9] . As endoscopic US is invasive and its performance requires special skills [1] , it is difficult to perform on patients with advanced gastric cancer.…”

Section: Resultsmentioning

confidence: 99%

“…It is also helpful for patients who have to undergo radiotherapy [8] . There have been many reports about preoperative staging in advanced gastric cancer with CT [1,7,9] and endoscopic US [2,3] . The staging accuracy by CT and US is 42%-69% and 81%-92%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of preoperative staging in advanced gastric cancer with MRI

Tang¹,

Guo²,

Xin³

2011

WJG

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AIM:To evaluate the application o� magnetic resonance imaging (MRI) to the preoperative staging o� advanced gastric cancer. METHODS:An MRI (SE sequence) was preoperatively per�ormed on 34 patients with advanced gastric cancer. The tumors were located at the cardia �undus in 11 patients, the corpus in 14, the antrum in ten and throughout the entire stomach in two. The images were analyzed and staged on the basis o� the criteria proposed by Matsushita M. The results were compared with the corresponding histopathologic findings to analyze the rate of diagnostic accordance. RESULTS:The diagnostic rate accuracy by MRI was 77.8% (seven out o� nince) �or T2 tumors; 77.3% (17 out o� 22) �or T3 tumors and 100% (three out o� three) �or T4 tumors, with the overall accuracy equaling 79.4%. When grades T3 and T4 tumors were considered as a single group to determine the presence or absence o� extraserosal invasion using MRI technology, the diagnostic accuracy was 88.3%. Statistically, MRI staging showed a signi�icant correlation with the corresponding histopathologic staging using the Spearman correlation test (r s′ = 0.743, P < 0.01). When the concordance between MRI and histopathologic staging results were studied according to tumor location, the staging accuracy was highest (90.9%) in tumors located in gastric cardia �undus.CONCLUSION: MR imaging is moderately valuable when staging advanced gastric cancer, especially �or tumors located in gastric cardia �undus.

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“…EGC. Studies in which dynamic or multiphase scanning was used to evaluate EGC achieved detection rates of 44-93.5% (1,3,(13)(14)(15)(16)). In our study, sensitivities of 40.2% and 97.7% were observed in patients with EGC and AGC, respectively, using S-CT alone.…”

Section: Discussionmentioning

confidence: 99%

Comparison of¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography, Hydro-Stomach Computed Tomography, and Their Combination for Detecting Primary Gastric Cancer

Jang

Chung

Song

et al. 2015

J Korean Soc Radiol

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Preoperative assessment of gastric carcinoma: value of two-phase dynamic CT with mechanical iv. injection of contrast material.

Cited by 111 publications

References 14 publications

Comparison between blinded and partially blinded detection of gastric cancer with multidetector CT using surgery and endoscopic submucosal dissection as reference standards

Comparison between blinded and partially blinded detection of gastric cancer with multidetector CT using surgery and endoscopic submucosal dissection as reference standards

Evaluation of preoperative staging in advanced gastric cancer with MRI

Comparison of¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography, Hydro-Stomach Computed Tomography, and Their Combination for Detecting Primary Gastric Cancer

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Preoperative assessment of gastric carcinoma: value of two-phase dynamic CT with mechanical iv. injection of contrast material.

Cited by 111 publications

References 14 publications

Comparison between blinded and partially blinded detection of gastric cancer with multidetector CT using surgery and endoscopic submucosal dissection as reference standards

Comparison between blinded and partially blinded detection of gastric cancer with multidetector CT using surgery and endoscopic submucosal dissection as reference standards

Evaluation of preoperative staging in advanced gastric cancer with MRI

Comparison of18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography, Hydro-Stomach Computed Tomography, and Their Combination for Detecting Primary Gastric Cancer

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Comparison of¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography, Hydro-Stomach Computed Tomography, and Their Combination for Detecting Primary Gastric Cancer