Abstract
Aim This study is aimed at comparing gastric cancer T and N staging between virtual monochromatic energy images and fusion images generated by dual-source computed tomography (DSCT) dual-energy mode data acquisition prospectively while measuring the iodine concentration of gastric cancer and lymph nodes at different T and N stages from iodine map retrospectively. Methods A total of 71 patients (50 males and 21 females; mean age: 59 ± 11 years) confirmed with gastric cancer by endoscopic biopsy with no neoadjuvant chemotherapy were enrolled for the CT examination before surgeries. The preoperative T and N staging results were compared between groups with pathological results as the gold standard. The iodine concentrations of the gastric lesions and LNs were measured on the iodine-based material decomposition images. All iodine concentration values were normalized against those in the abdominal aorta and defined as normalized iodine concentration (nIC) values. The short axis length of LNs and nIC values were statistically analyzed. Results Group A was better than group B for T3 and T4 staging. No statistically significant difference in the overall accuracies for N staging was found between groups. For the late arterial and delayed phases, T3 and T4 nIC values of the extraserosal adipose tissue showed statistically significant differences. The nIC values between N0 and Nm (N1–N3) showed statistically significant differences in the portal phase only. Conclusions T3 and T4 nIC values of the extraserosal adipose tissue showed statistically significant differences. Hence, dual-source CT may be helpful in the differential diagnosis between T3 and T4.
Highlights
Gastric cancer is one of the most common cancers worldwide
The prognosis of patients depends on the clinical stage of cancer [7], including the invasion depth to the gastric wall, LN metastasis, and distant metastasis
The successful introduction of neoadjuvant chemotherapy in treating locally advanced gastric cancer is crucial in the preoperative imaging identification of responding patients to customize treatment and reduce health care costs [9,10,11]
Summary
Gastric cancer is one of the most common cancers worldwide. According to the report of GLOBOCAN 2012 from the International Agency for Research on Cancer, 952,000 new gastric cancer cases and 723,000 deaths due to gastric cancer were reported all over the world in 2012 [1]. A large number of preoperative staging studies on gastric cancer were performed using multidetector row computed tomography (MDCT) [3]. Compared with endoscopic ultrasonography (EUS), computed tomography (CT) is more valuable for TNM staging of gastric cancer [4, 5]. The prognosis of patients depends on the clinical stage of cancer [7], including the invasion depth to the gastric wall, LN metastasis, and distant metastasis. Of these three aspects, the metastasis of LN is crucial. The present study focused on T and N staging of gastric cancer using dualenergy mode DSCT
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have