Contribution of DECT in detecting serosal invasion of gastric cancer

Ali̇ Küpeli̇,Eser Bulut,Gürkan Danişan,Ali̇ Güner,Ayşegül Cansu,Mehmet Soytürk

doi:10.3906/sag-1811-168

Abstract

Background/aim This study aimed to investigate the relationship between the iodine concentration (IC) of perigastric fat tissue as assessed by dual-energy computed tomography (DECT) and serosal invasion of gastric cancer.Materials and methods A total of 41 patients underwent preoperative staging evaluation for gastric cancer using DECT between July 2015 and March 2018. Patients were divided into 2 groups based on pathology results: serosal invasion (stage T4a) and intact serosa (stages T1–T3). Cutoff values, the diagnostic efficacy of IC in the perigastric fat tissue, and the perigastric fat tissue/tumor (P/T) ratio were determined.Results Among the 41 patients, 22 had stage T4a gastric cancer and 19 patients had gastric cancer with a stage lower than T4a. The mean IC of perigastric fat tissue and the P/T ratio were significantly higher in patients with serosal invasion than in those with intact serosa (P < 0.001). During the arterial phase, the area under the curve (AUC) was 0.915 and 0.854 for the IC of perigastric fat tissue and the P/T ratio, respectively. During the venous phase, the AUC was 0.890 and 0.876 for the IC of perigastric fat tissue and the P/T ratio, respectively.Conclusion The IC in the perigastric fat tissue seems to be a reliable indicator for serosal invasion of gastric cancer.

Highlights

Gastric cancer remains one of the most important causes of cancer-related deaths worldwide [1,2,3]
The mean iodine concentration (IC) of perigastric fat tissue and the perigastric fat tissue/tumor (P/T) ratio were significantly higher in patients with serosal invasion than in those with intact serosa (P < 0.001)
The IC in the perigastric fat tissue seems to be a reliable indicator for serosal invasion of gastric cancer

Summary

Introduction

Gastric cancer remains one of the most important causes of cancer-related deaths worldwide [1,2,3]. Correct diagnosis and precise preoperative staging of gastric cancer are very important because these patients can be treated with laparoscopic or minimally invasive surgery [4]. The TNM staging system is usually used to stage gastric cancer, and T4 is described as a tumor that has spread through all the muscle layers outside the stomach and invades the serosa or adjacent structures [3]. Selection of the appropriate treatment options, including neoadjuvant chemotherapy or multiorgan surgery, depends on correct differentiation between stage T4 gastric cancer and T3 or earlier stages [5,6,7]. Computed tomography (CT) is the most common method used to identify the stages of gastric cancer and assess the local extension of the tumor, nodal disease, and

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Conclusion