Difference in Perfusion Parameters Between Gastric Cancer and Gastric Stromal Tumors: Evaluation With Oral Contrast Plus Contrast-Enhanced Ultrasonography.

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

doi:10.3389/fonc.2020.00532

Abstract

Objective: To explore the difference of perfusion parameters between gastric cancer (GC) and gastric stromal tumors (GSTs) by using oral contrast plus contrast-enhanced ultrasonography (OC+CEUS).Methods: We retrospectively reviewed 149 patients with histologically confirmed gastric lesions (80 patients with GC and 69 patients with GST). OC+CEUS was performed in all patients in the GC group and the GST group before surgery. The cine loops of OC+CEUS of all cases were analyzed. The perfusion parameters including arrival time (AT), time to peak (TTP), basal intensity (BI), and peak intensity (PI) were obtained via a program designed for autotracking contrast quantification (ACQ). The between-group differences in these parameters were compared.Results: According to time-intensity curve (TIC) analysis, high-risk GST had higher PI than low-risk GST (P < 0.05). GC had faster AT and higher PI than normal gastric wall (P < 0.05); GST had higher PI than normal gastric wall (P < 0.05). Furthermore, the GC group had faster AT and higher PI than the GST group (P < 0.05). In contrast, the difference in BI and peak time (TTP) between the groups was not significant (P > 0.05).Conclusion: AT and PI differ significantly between the GC group and the GST group. As a new method, OC+CEUS has value for the differential diagnosis of GC and GST.

Highlights

Gastric cancer (GC) is a malignant tumor that originated from gastric epithelial tissue
This study aimed to evaluate the differences in the perfusion parameters between the GC and Gastric stromal tumor (GST) groups, and to emphasize the practicability and usefulness of Oral contrast plus contrast-enhanced ultrasonography (OC+CEUS) in the clinical differential diagnosis of GC and GST
The gastric cavity performed as a midgray, homogeneous region that acts as an acoustic window and improves the visualization of the inner wall

Summary

Introduction

Gastric cancer (GC) is a malignant tumor that originated from gastric epithelial tissue It is the fourth most common cancer with ∼1 million new cases annually and is the third leading cause of cancer-associated death globally [1, 2]. Gastric stromal tumor (GST) is a neoplasm that originated from gastric mesenchymal tissue with potential malignant features. It is a relatively rare tumor type, but can be readily cured in many cases, with patients having 5-years OS rates of 60–85% [6]. The prognosis for GST patients with advanced disease has improved significantly in recent years, whereas similar gains have not been made with respect to GC [3, 7]. Due to the large difference in the treatment and prognosis between GA and GST, it is necessary to differentiate GA from GST before therapeutic strategy is planned

Methods

Results

Conclusion