T Staging of Gastric Cancer: Role of Multi–Detector Row CT

Kumano, Seishi; Murakami, Takamichi; Kim, Tonsok; Hori, Masatoshi; Iannaccone, Riccardo; Nakata, S; Onishi, Hiromitsu; Osuga, Keigo; Tomoda, Kaname; Catalano, Carlo; Nakamura, Hajime

doi:10.1148/radiol.2373041380

Cited by 119 publications

(90 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For diagnoses of serosal invasion, MDCT findings were also considered [10]. A classification of cT4a was made when all layers of the gastric wall were visible on MDCT, indicating hypertrophy of the entire gastric wall and irregularities in the surrounding fatty tissue structures.…”

Section: Criteria For Determining the Preoperative Tumor Depthmentioning

confidence: 99%

“…With advancements in endoscopy [8], endoscopic ultrasonography [9], and multidetector computed tomography (MDCT) [10], several techniques have been established that provide satisfactory diagnostic data regarding the appropriate depth of invasion. A previous study regarding LN evaluation reported the improved diagnostic accuracy of MDCT [11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of clinical tumor–node–metastasis staging on survival in gastric carcinoma patients receiving surgery

et al. 2016

View full text Add to dashboard Cite

Background Preoperative clinical staging of gastric cancer is used to determine therapeutic strategies. However, the impact of the clinical stage on survival has not been completely investigated, although the relationship between pathologic staging and survival outcome has been reported. The aim of the present study was to clarify the predictability of patient survival based on clinical staging and to evaluate the usefulness of staging as an indicator for selecting the treatment modality. Methods A total of 3033 patients who underwent surgery for gastric cancer were included. A survival analysis was conducted based on the seventh edition of the tumor-nodemetastasis (TNM) clinical staging system of the American Joint Committee on Cancer. The predictive ability of the TNM clinical stage for survival was evaluated by Harrell's C-index, a measure of the separation of survival distributions.Results The cumulative 5-year survival rates according to the clinical stage were 94.3 % (IA), 84.7 % (IB), 71.7 % (IIA), 56.1 % (IIB), 55.7 % (IIIA), 42.3 % (IIIB), 22.8 % (IIIC), and 9.1 % (IV). Although no significant difference was observed between clinical stages IIB and IIIA (p = 0.865), significant differences existed between all other clinical stages (p \ 0.001). Harrell's C-index applied to these results was 0.825 (95 % confidence interval 0.819-0.831). Conclusions The seventh edition of the TNM clinical staging system has a strong prognostic ability with a satisfactory C-index and should be considered valuable for selecting therapeutic strategies for the treatment of gastric cancer.

show abstract

Section: Criteria For Determining the Preoperative Tumor Depthmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of clinical tumor–node–metastasis staging on survival in gastric carcinoma patients receiving surgery

et al. 2016

View full text Add to dashboard Cite

show abstract

“…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%

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

et al. 2011

View full text Add to dashboard Cite

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

show abstract

“…Its accuracy has constantly improved, for detecting both the invasion of gastric wall, ranging from 69 to 89 % [11][12][13], and nodal involvement, ranging from 69 to 92 % [14,15]. Nevertheless, MDCT involves the use of ionizing radiation and cannot adequately differentiate all the gastric wall layers.…”

Section: Introductionmentioning

confidence: 99%

Preoperative locoregional staging of gastric cancer: is there a place for magnetic resonance imaging? Prospective comparison with EUS and multidetector computed tomography

et al. 2015

View full text Add to dashboard Cite

Background The aim of this study was to prospectively compare the diagnostic performance of magnetic resonance imaging (MRI), multidetector computed tomography (MDCT) and endoscopic ultrasonography (EUS) in the preoperative locoregional staging of gastric cancer. Methods This study had Institutional Review Board approval, and informed consent was obtained from all patients. Fifty-two patients with biopsy-proven gastric cancer underwent preoperative 1.5-T MRI, 64-channel MDCT and EUS. All images were analysed blind, and the results were compared with histopathological findings according to the seventh edition of the TNM classification. After the population had been divided on the basis of the local invasion (T1-3 vs T4a-b) and nodal involvement (N0 vs N?), sensitivity, specificity, positive and negative predictive value, and accuracy were calculated and diagnostic performance measures were assessed using the McNemar test. Results For T staging, EUS showed higher sensitivity (94 %) than MDCT and MRI (65 and 76 %; p = 0.02 and p = 0.08). MDCT and MRI had significantly higher specificity (91 and 89 %) than EUS (60 %) (p = 0.0009 and p = 0.003). Adding MRI to MDCT or EUS did not result in significant differences for sensitivity. For N staging, EUS showed higher sensitivity (92 %) than MRI and MDCT (69 and 73 %; p = 0.01 and p = 0.02). MDCT showed better specificity (81 %) than EUS and MRI (58 and 73 %; p = 0.03 and p = 0.15). Conclusions Our prospective study confirmed the leading role of EUS and MDCT in the staging of gastric cancer and did not prove, at present, the value of the clinical use of MRI.

show abstract

T Staging of Gastric Cancer: Role of Multi–Detector Row CT

Abstract: Multi-detector row CT scanning of patients with gastric cancer gave 93% accuracy in the assessment of serosal invasion in patients with gastric cancer.

Cited by 119 publications

References 21 publications

Impact of clinical tumor–node–metastasis staging on survival in gastric carcinoma patients receiving surgery

Impact of clinical tumor–node–metastasis staging on survival in gastric carcinoma patients receiving surgery

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

Preoperative locoregional staging of gastric cancer: is there a place for magnetic resonance imaging? Prospective comparison with EUS and multidetector computed tomography

Contact Info

Product

Resources

About