Value of multidetector‐row computed tomography in the preoperative T and N staging of gastric carcinoma: A large‐scale Chinese study

Yan, Chao; Zhu, Zhenggang; Yan, Min; Zhang, Huan; Pan, Zhengying; Xiang, Min; Chen, Mingmin; Liu, Bingya; Yin, Hao; Lin, Ying‐Chu

doi:10.1002/jso.21316

Cited by 91 publications

(69 citation statements)

References 40 publications

(68 reference statements)

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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%

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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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Section: Performance Characteristics Of Pre-operative Imaging Studiesmentioning

confidence: 99%

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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“…The overall npv of ct in detecting locally invasive ga (ajcc6 T4) ranges from 67% to 100% in reports published since 2000 [11][12][13][14][15][16][17][18] . Among studies assessing the preoperative detection of local invasion, only a handful included 10 patients or more with pathologically confirmed local invasion 14,[16][17][18] , presumably because the remainder did not undergo resection 3 .…”

Section: Discussionmentioning

confidence: 99%

“…Among studies assessing the preoperative detection of local invasion, only a handful included 10 patients or more with pathologically confirmed local invasion 14,[16][17][18] , presumably because the remainder did not undergo resection 3 . Among the included patients, the npv of ct in detecting local invasion ranged from 67% to 99% 14,[16][17][18] , which encompasses the npv of 86.9% for local invasion reported here.…”

Section: Discussionmentioning

confidence: 99%

Negative Predictive Value of Preoperative Computed Tomography in Determining Pathologic Local Invasion, Nodal Disease, and Abdominal Metastases in Gastric Cancer

et al. 2016

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“…In the UICC/AJCC system, N stage is defined according to the distance of the perigastric regional lymph nodes from the edge of the primary tumour or the total number of lymph node metastases present. 31,32 Our meta-analysis only compared the performance of MRI to identify N0 vs N1 disease. The Cochran Q test ( Figure 6) confirmed that there was little heterogeneity across the studies for N stage.…”

Section: Diagnostic Accuracy Of Lymph Node Status (N Stage)mentioning

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

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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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Value of multidetector‐row computed tomography in the preoperative T and N staging of gastric carcinoma: A large‐scale Chinese study

Abstract: The clinical value of MDCT in the preoperative T and N staging of gastric carcinoma is relatively high. MDCT can be the first choice for the preoperative evaluation of patients with gastric carcinoma.

Cited by 91 publications

References 40 publications

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

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

Negative Predictive Value of Preoperative Computed Tomography in Determining Pathologic Local Invasion, Nodal Disease, and Abdominal Metastases in Gastric Cancer

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

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