Preoperative Tumor Staging of Gastric Cancer: Comparison of Double Contrast‐Enhanced Ultrasound and Multidetector Computed Tomography

Abstract

Objectives-The purpose of this study was to compare the sensitivity and specificity of double contrast-enhanced ultrasound (CEUS) and multidetector computed tomography (MDCT) in the preoperative tumor staging of gastric cancer (GC) to stratify patients for suitable treatment.Methods-Fifty-four patients with GC proved by histologic findings were included. The sensitivity and specificity of double CEUS and MDCT for tumor staging were calculated and compared. The differences between these methods were evaluated by using the area under the curve (AUC) from a receiver operating characteristic curve analysis.Results-There were no significant differences in AUC values for T1 and T2 stages between double CEUS and MDCT (P = .190 and .256, respectively). However, the sensitivity of double CEUS in the detection of the T1 stage was higher than that of MDCT (88% versus 75%). The AUC values of MDCT for T3 and T4 stages were 0.833 and 0.905, which were both significantly higher than those of double CEUS (0.759 and 0.696; P < .05). The sensitivities of double CEUS and MDCT for the T3 stage were both 89%, but the accuracy and specificity of double CEUS were lower than those of MDCT (76% versus 83% and 63% versus 78%). The specificities of double CEUS and MDCT for the T4 stage were both 98%, but the accuracy and sensitivity of double CEUS were lower than those of MDCT (85% versus 94% and 42% versus 83%).Conclusions-Multidetector CT is superior to double CEUS for T3 and T4 GC, and double CEUS may be regarded as an important complementary method to MDCT.

Diagnostic Accuracy of Double Contrast-Enhanced Ultrasonography in Clarifying Tumor Depth (T Stage) of Gastric Cancer: Meta-analysis

“…However, the heterogeneity between specificities was not good. When the articles by He et al (2019) and Zheng et al (2011) were excluded, the p values were >0.05, indicating that the two articles had a great impact on heterogeneity. Separately, each stage reduced the heterogeneity after excluding the article by He et al (2019).…”

“…When the articles by He et al (2019) and Zheng et al (2011) were excluded, the p values were >0.05, indicating that the two articles had a great impact on heterogeneity. Separately, each stage reduced the heterogeneity after excluding the article by He et al (2019). Therefore, the cause of heterogeneity in this review was associated with the study by He et al (2019).…”

“…When the six articles were excluded from the T2 stage, all p values were <0.05, and I 2 was >50. After exclusion of the study by He et al (2019), no heterogeneity was found in the remaining five data subsets in T3 and T4 stages (p values = 0.12 and 0.83, I 2 = 44.8 and 0).…”

“…After excluding the study by He et al (2019) with the lowest sensitivity and that by Zheng et al (2011) with the lowest specificity from T1ÀT2, no heterogeneity was found with the remaining four data subsets (p values>0.05, I 2 = 0), and the sensitivity and specificity were 0.96 (95% CI: 0.92À0.98) and 0.93 (95% CI: 0.90À0.95), respectively. When the six articles were excluded from the T2 stage, all p values were <0.05, and I 2 was >50.…”

“…Therefore, we carried out a meta-analysis of the eligible studies reporting relevant data. For this analysis, six studies (Wang et al 2009;Chen et al 2010;Zheng et al 2011;Li et al 2012;He et al 2019; were available, including a total of 926 patients.…”