Comparing single oral contrast-enhanced ultrasonography and double contrast-enhanced ultrasonography in the preoperative Borrmann classification of advanced gastric cancer.

Liang Wang,Lingling Zhou,Hongju Kou,Mingdong Lu,Huiliao He,Xiaohua Wang,Yan Yang

doi:10.18632/oncotarget.23819

Abstract

ObjectivesTo evaluate the accuracy of double contrast-enhanced ultrasonography (DCEUS) in preoperative Borrmann classification of advanced gastric cancer (AGC).Materials and MethodsA total of 162 patients histologically confirmed AGC were enrolled into this study. Single oral contrast-enhanced ultrasonography (SOCEUS) were performed in 80 patients and DCEUS (intravenous microbubbles combined with oral contrast-enhanced ultrasound) were performed in 82 patients preoperatively. The findings of the histopathologic examination of resected specimens after surgery were considered as gold standard. The accuracy of SOCEUS was compared with the accuracy of DCEUS in determining Borrmann classification. Interobserver agreement between two sonographyers of SOCEUS and DCEUS had also been assessed.ResultsThe accuracy of SOCEUS and DCEUS in Borrmann classification of advanced gastric cancer were 78.75% and 91.46% respectively. There was a significant difference between two methods (χ2 = 5.186, P < 0.05). The interobserver agreement of two methods was both excellent for assessing the Borrmann classification with a Kappa value of 0.777 by SOCEUS and 0.844 by DCEUS.ConclusionsDCEUS is a valuable method for Borrmann classification with its high accuracy preoperatively. It should be used widely.

Highlights

Gastric cancer affects almost 1,000,000 individuals per year and remains the third most frequent cause of cancer deaths worldwide [1, 2]
The interobserver agreement of two methods was both excellent for assessing the Borrmann classification with a Kappa value of 0.777 by Single oral contrast-enhanced ultrasonography (SOCEUS) and 0.844 by double contrast-enhanced ultrasonography (DCEUS)
DCEUS is a valuable method for Borrmann classification with its high accuracy preoperatively

Summary

Introduction

Gastric cancer affects almost 1,000,000 individuals per year and remains the third most frequent cause of cancer deaths worldwide [1, 2]. The outcome of gastric carcinoma post-treatment has been markedly improved with the development of diagnostic imaging modalities, increased early detection, and popularization of standard surgical methods. Advanced gastric carcinoma remains a disease with a poor prognosis [5]. There should be reasonable and individualized comprehensive treatment strategies for patients with gastric cancer [7]. To classify the advanced gastric cancer is one of the crucial factors of therapeutic strategy. The classification of advanced gastric cancer according to Borrmann’s criteria is still widely used around the world [8]. Accurate Borrmann classification and costefficient preoperative evaluation have been required for the development of a reasonable operation program and assessment of the prognosis

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