Diagnosis of the Invasion Depth of Gastric Cancer Using MDCT With Virtual Gastroscopy: Comparison With Staging With Endoscopic Ultrasound
- 1 October 2011
- journal article
- research article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 197 (4), 867-875
- https://doi.org/10.2214/ajr.10.5872
Abstract
OBJECTIVE. The objectives of this study were to retrospectively evaluate the lesion detection rate of gastric cancer using only virtual gastroscopy generated from MDCT images and the accuracy of invasion depth diagnosis (T staging) using virtual gastroscopy together with contrast-enhanced MDCT with multiplanar reconstruction (MPR) images (virtual gastroscopy with MPR), and to compare the diagnostic performance between virtual gastroscopy with MPR images and endoscopic ultrasound. MATERIALS AND METHODS. The subjects consisted of 175 patients with a total of 186 endoscopically proven gastric cancer lesions. All patients underwent dynamic MDCT (arterial and venous phase) for preoperative staging and underwent surgery or endoscopic treatment. In 129 patients (135 lesions) who were also examined using endoscopic ultrasound, the T staging accuracy was also compared between the two modalities. Two endoscopists independently evaluated the lesion detection rate on virtual gastroscopy images alone and determined the T stage on virtual gastroscopy with MPR images. The T staging included the ability to differentiate T1a from T1b lesions. RESULTS. The overall lesion detection rate was 67.7% (126/186). The detection rates of T1a, T1b, and T2 or deeper were 37.8% (28/74), 75.0% (39/52), and 98.3% (59/60), respectively, showing statistically significant differences (p < 0.001). The T staging accuracies were 82.2% (111/135) using virtual gastroscopy with MPR images and 83.7% (113/135) using endoscopic ultrasound, showing no statistically significant difference (p = 0.850). The main causes of over- and understaging were an ulcer or ulcer scar and poorly differentiated adenocarcinomas, non-solid type, respectively. CONCLUSION. Virtual gastroscopy with MPR imaging is a useful modality in the T staging of gastric cancer.Keywords
This publication has 32 references indexed in Scilit:
- Diagnostic Performance of 64-Channel Multidetector CT in the Evaluation of Gastric Cancer: Differentiation of Mucosal Cancer (T1a) from Submucosal Involvement (T1b and T2)Radiology, 2010
- Preoperative T staging of gastric carcinoma obtained by MDCT vessel probe reconstructions and correlations with histological findingsEuropean Radiology, 2009
- Prevalence and prognosis of gastric cancer detected by screening in a large Japanese population: Data from a single institute over 30 yearsJournal of Gastroenterology and Hepatology, 2007
- Imaging in Local Staging of Gastric Cancer: A Systematic ReviewJournal of Clinical Oncology, 2007
- Endoscopic submucosal dissection of early gastric cancerThe Esophagus, 2006
- T Staging of Gastric Cancer: Role of Multi–Detector Row CTRadiology, 2005
- Gastric cancer by multidetector row CT: preoperative stagingAbdominal Radiology, 2005
- Current status of laparoscopic gastrectomy for cancer in JapanSurgical Endoscopy, 2003
- Pathology and prognosis of gastric carcinomaCancer, 2000
- Clinicopathologic characteristics and prognostic factors in 10 783 patients with gastric cancerGastric Cancer, 1998