Abstract
To investigate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in the diagnosis of gastric tumors and discuss the diagnostic importance and potential use of apparent diffusion coefficient (ADC) measurements. Beginning in March 2009, DW-MRI was added to the routine abdominal and pelvic MR examination for all patients imaged at our institution. A total of 21 patients (12 men and 9 women; mean age 55±6.3SD, range: 39-74 years) with known gastric malignancy were referred to our MR unit. All MRI examinations were performed using a 1.5-T MRI scanner (Magnetom Avanto, Siemens Healthcare). The evaluation of the DW-MRI examinations was made by radiologists' consensus. Changes in the signal intensity of the lesions were determined by their appearance in images at b=50, 400, and 800 s/mm(2) and in ADC maps. Results were compared with histopathological findings. All of the gastric tumors in this study showed high signal intensity in DW-MRI and low signal intensity in ADC maps. Mean ADC values for gastric tumor and normal gastric wall were 0.892±0.23 SD mm(2)/s and 1.453±0.35 SD mm(2)/s respectively. The mean ADC values of gastric tumors were significantly lower than that of the normal gastric wall. DW-MRI and ADC values together can successfully differentiate gastric tumors from normal gastric wall.
Highlights
Gastric cancer is the second leading cause of cancer death worldwide, there is considerable geographical variation
In patients affected by gastric carcinoma, early detection of the disease is the principal parameter in planning treatment and is a determinant of prognosis
In this study we aim to evaluate the potential use of diffusion-weighted magnetic resonance imaging (DW-magnetic resonance imaging (MRI)) in the evaluation of gastric cancer and discuss the diagnostic importance of apparent diffusion coefficient (ADC) measurement
Summary
Gastric cancer is the second leading cause of cancer death worldwide, there is considerable geographical variation. These cancers usually show metastatic spread at the time they are identified [1]. There are many imaging modalities used to evaluate this malignancy. US is noninvasive, nonionizing, readily available, and lower in cost than the other methods. It is recognized as an operator-dependent technique. CT is undoubtedly the most-used imaging modality in the evaluation of gastric tumors. It is non-invasive, but carries the risk of radiation. PET has been recognized as a useful diagnostic technique in clinical oncology [4], but experience with its use in evaluating stomach cancer is limited
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