Double contrast–enhanced ultrasonography for the preoperative evaluation of gastric cancer: A comparison to endoscopic ultrasonography with respect to histopathology

Abstract

Background This study was designed to compare the accuracy of endoscopic ultrasound (EUS) with double contrast–enhanced ultrasound (DCUS) in the staging of gastric malignancies. DCUS is a transabdominal ultrasound technique using both intravenous and intraluminal contrast to enhance sonographic visualization. Methods This retrospective study included 162 patients with biopsy-proven gastric cancer who underwent DCUS and EUS preoperatively with the ultrasound results compared with the pathologic findings of the resected specimens. Results The overall accuracy of DCUS and EUS for tumor (T) staging was 77.2% and 74.7%, respectively . Comparison of ultrasound techniques for T staging revealed that DCUS was superior to EUS only for a tumor depth of T3 (chi-square, P = .025). Lymph nodes were staged correctly with DCUS and EUS in 78.4% and 57.4% of cases, respectively (chi-square, P = .001). Conclusions DCUS offers a noninvasive approach for the staging of gastric cancer. DCUS was comparable to EUS in tumor depth evaluation but offered an advantage in lymph node detection.