Clinical Research of Combined Application of DCEUS and Dynamic Contrast-Enhanced MSCT in Preoperative cT Staging of Gastric Cancer.

Junling Wang,Zhijie Zhang,Jie Li,Chao Jing,Xia Li,Alamgeer Yuchi

doi:10.1155/2021/9868585

Junling Wang, Zhijie Zhang + Show 4 more

Open Access

https://doi.org/10.1155/2021/9868585

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Abstract

Purpose To investigate the clinical value of double contrast-enhanced ultrasound (DCEUS) combined with dynamic contrast-enhanced multislice CT (MSCT) in preoperative T staging of gastric cancer (GC). Methods 206 patients with GC confirmed by preoperative gastroscopy from February 2019 to February 2021 were collected, all patients were examined by DCEUS and dynamic contrast-enhanced MSCT before operation, and the invasion depth (T staging) of GC was evaluated. The diagnosis results of DCEUS, dynamic contrast-enhanced MSCT, and combined diagnosis of DCEUS and MSCT methods (D&M method) were compared with the pathological staging results (gold standard). Results The correct diagnosis rate of MSCT was 27.27% in T1 staging, 55.56% in T2 staging, 42.11% in T3 staging, 59.29% in T4 staging, and 55.34% in summation. The correct diagnosis rate of DCEUS was 90.91% in T1 staging, 88.89% in T2 staging, 78.95% in T3 staging, 82.86% in T4 staging, and 83.98% in summation. The correct diagnosis rate of the D&M method was 100.00% in T1 staging, 94.44% in T2 staging, 89.47% in T3 staging, 93.57% in T4 staging, and 93.69% in summation. The D&M method had higher correct diagnosis rate than MSCT or DCEUS alone, the correct diagnosis rate of the D&M method in T1, T2, T3, and T4 staging was significantly higher than that of MSCT (P < 0.05). The correct diagnosis rate of the D&M method in T1, T3, and T4 was significantly higher than that of DCEUS (P < 0.05). The Youden index of preoperative T1, T2, T3, and T4 staging of GC by the D&M method was 99.49%, 94.44%, 84.13%, and 90.54%, respectively, and the Kappa values of these were 0.954, 0.966, 0.707, and 0.881, respectively. Conclusions Dynamic contrast-enhanced MSCT combined with DCEUS in the diagnosis of preoperative cT staging of GC has more validity, reliability, and revenue than the using of MSCT or DCEUS alone, which is an image evaluation method worthy of clinical promotion.

Highlights

Gastric cancer (GC) is the most common malignant tumor in the world, the incidence rate of malignant tumors is fifth, and the mortality rate is third [1]
Low dose test method was used: 16 ml of test dose was injected first, and the drug was injected in a bolus. e scan was performed in the pulse phase, portal vein phase (20 s after the arterial phase), and equilibrium phase (60 s after the portal vein phase). e multislice CT (MSCT) results and preoperative clinical T staging (cT) staging evaluation of all patients in this study were performed by two senior doctors in the radiology department of Qilu Hospital of Shandong University
76.80%, respectively, by the double contrast-enhanced ultrasound (DCEUS) method; and the same was 99.49%, 94.44%, 84.13%, and 90.54%, respectively, by the D&M method, which shows that the D&M method has better validity in preoperative cT staging of GC. e Kappa value of preoperative T1, T2, T3, and T4 staging was 0.382, 0.598, 0.024, and 0.383, respectively, by the MSCT method; the same was 0.823, 0.913, 0.438, and 0.711, respectively, by the DCEUS method; and the same was 0.954, 0.966, 0.707, and 0.881, respectively, by the D&M method. is means the D&M method has better reliability in preoperative cTstaging

Summary

Introduction

Gastric cancer (GC) is the most common malignant tumor in the world, the incidence rate of malignant tumors is fifth, and the mortality rate is third [1]. Accurate evaluation of the clinical staging of GC before formulating the treatment plan is of great significance for the selection of treatment plan and the preliminary evaluation of patients’ prognosis. E common methods for preoperative diagnosis of GC include fiberoptic gastroscopy and histological examination. Ere are a lot of clinical research methods for preoperative clinical T staging (cT) of GC, including endoscopic ultrasonography [5], dynamic contrast-enhanced multislice CT (MSCT) [6], magnetic resonance imaging (MRI) [7], and double contrast-enhanced ultrasound (DCEUS) [8].

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