Preoperative Staging Of Gastric Carcinoma Research Articles

Role of Multidetector Computed Tomography in Gastric Cancers

Background: Gastric cancer is the third most common cause of cancer-related death in the world. Currently, multislice computed tomography (MSCT) is a valuable tool for detection, staging, surveillance, and post-treatment evaluation of gastric neoplasm. Objective: The aim of this work is to clarify the role of multidetector CT in diagnosis and preoperative staging of gastric carcinoma. Patients and methods: The present study was conducted between October 2017 and June 2019 on 60 patients (26 males and 34 females) with age ranged from 28 to 73 years with mean age of 53 years. The patients were complaining of symptoms of gastric cancer or as a follow-up study for gastric cancer, referred to the CT Unit in Tanta University Hospital, Tanta Oncology Center and Health Insurance Hospital from the Oncology Department. Results: In our study we found that there was a significant relationship between pathological and CT staging by using MPR. CT with MPR was specific and accurate in diagnosis of all stages of gastric cancer with specificity ranged between (95-100%) and accuracy ranged between (94.5-97.5%). However, it showed lowest sensitivity in diagnosis of stage 1 of gastric cancer. On the other hand, it showed highest sensitivity (97.5%) in diagnosis of stage IV. Conclusion: MSCT is a valuable tool for detection, staging, surveillance, and post-treatment evaluation of gastric neoplasm.

Comparative Study of Transabdominal Ultrasonography and Multidetector Row Computed Tomography in Preoperative Staging of Gastric Carcinoma

Comparative Study of Transabdominal Ultrasonography and Multidetector Row Computed Tomography in Preoperative Staging of Gastric Carcinoma

The utility of MRI for pre-operative T and N staging of gastric carcinoma: a systematic review and meta-analysis.

To perform a meta-analysis and literature review regarding the diagnostic accuracy of MRI for pre-operative tumour depth invasion (T) and regional lymph node invasion (N) staging of gastric carcinoma (GC). Articles were identified through systematic search of Medline, PubMed, Cochrane Library, Web of Science, Springerlink and several Chinese databases. The study quality was assessed by the quality assessment for studies of diagnostic accuracy. 2 reviewers independently extracted and assessed the data from 11 eligible studies. A meta-analysis was then carried out. Subgroup and sensitivity analyses were also performed. 11 studies (439 patients) were finally included in the current review. Among these studies, the significant evidence of heterogeneity was only discovered for specificity in T4 stage (I(2) = 59.8%). Pooled sensitivity and specificity of MRI to diagnose T stage tumour (T3-4 vs T1-2) were 0.93 [95% confidence interval (CI), 0.89-0.96] and 0.91 (95% CI, 0.87-0.95), respectively. Pooled estimates of sensitivity and specificity of MRI to diagnose N stage tumour (N0 vs N+) were 0.86 (95% CI, 0.80-0.92) and 0.67 (95% CI, 0.54-0.79), respectively. Subgroup analyses showed that diffusion-weighted imaging was more helpful for T staging. The present systematic review suggests that MRI has a good diagnostic accuracy for pre-operative T staging of GC and should be widely used in clinical work. However, the ability for N staging is relatively poor on MRI. In the pre-operative staging of GC, MRI was a useful tool and may enhance accuracy for the T staging of advanced GC.

Clinical application of multi-slice spiral computed tomography in the preoperative staging of gastric carcinoma

To evaluate the application of multi- slice spiral computed tomography (MSCT) in the preoperative staging of gastric carcinoma. Eighty- nine cases of gastric carcinoma confirmed by endoscopic biopsy (including 49 men and 40 women) were collected between June 2004 and March 2006. MSCT was performed one week before operation and all the images were read by two radiologists. The results were compared with the postoperative pathologic findings. In general, the accuracy of MSCT in determining the T stage of gastric carcinoma was 68.7% based on axial and MPR images. The accuracy of diagnosis for T (1) was 90.0% (9/10), for T(2) was 82.8% (24/29), for T(3) was 69.6% (16/23) and for T(4) was 52.4% (11/21) respectively. The accuracy for MSCT in determining the N stage of gastric carcinoma was 51.8% in general. The accuracy of diagnosis for N(0) was 44.0% (11/25), for N(1) was 72.0% (18/25), for N(2) was 46.4% (13/28) and for N(3) was 40.0% (2/5) respectively. The accuracy of diagnosis for distant metastasis (M(1)) was 90% (9/10). The accuracy of MSCT in preoperative staging of gastric carcinoma is relatively high. It is easily accepted by the patients as a practical and noninvasive technique of gastric carcinoma staging.

Magnetic Resonance Imaging for Local Staging of Gastric Carcinoma

Preoperative staging of gastric carcinoma is limited by the fact that available imaging modalities do not enable accurate evaluation of the depth of infiltration of the gastric wall. The aim of this study was to evaluate the efficiency of conventional magnetic resonance imaging (MRI) in local staging of gastric carcinoma. Sixty-five specimens of patients with proven gastric carcinoma were examined immediately after gastrectomy. Examination was performed with a 1-T MRI and included T1-weighted, T2-weighted, and opposed phase images. Images were analyzed for the number of visible wall layers and their signal intensity characteristics, for tumor localization and depth of infiltration. T-stage was classified according to the TNM system. Finally, the staging by MRI was compared with the histopathological staging of the specimens. The mucosal, submucosal, and proper muscle layers could be differentiated by the typical signal intensities. Depiction of the subserosa or serosa was not possible. In 65 specimens, 67 carcinomas were found by the pathologist. Sixty-four of 67 (96%) histologically proven carcinomas were correctly localized by MRI; T-staging accuracy was 50% only, mainly because of overstaging pT2 tumors as T3. MRI enables differentiation of gastric wall layers and, therefore, technically allows the evaluation of the local tumor stage of gastric carcinomas. However, infiltration of the subserosal and serosal layer cannot be proved accurately. Overstaging pT2 tumors is one of the most predominant problems. Yet further technical developments in high-resolution imaging of the gastric wall may improve T-staging in the near future and overcome today's staging limitations.

Dedicated multidetector CT of the stomach: spectrum of diseases.

Multidetector computed tomography (CT) offers new opportunities in imaging of the gastrointestinal tract. When thin collimation is used, near-isotropic imaging of the stomach is possible, allowing high-quality multiplanar reformation and three-dimensional reconstruction of gastric images. Proper distention of the stomach and optimally timed administration of intravenous contrast material are required to detect and characterize disease. In contrast to gastroscopy and double-contrast studies of the stomach, CT provides information about both the gastric wall and the extragastric extent of disease. Preoperative staging of gastric carcinoma appears to be the main clinical indication for multidetector CT. In addition, multidetector CT allows detection of other gastric malignancies (lymphoma, carcinoid tumors, metastases, gastrointestinal stromal tumors) and benign gastric tumors (neural tumors, polyps). Gastric inflammation (gastritis, ulcers, Ménétrier disease) and miscellaneous gastric conditions (emphysema, gastric outlet obstruction, varices) can also be visualized with multidetector CT. Multidetector CT is a valuable tool for the evaluation of gastric wall disease and serves as an adjunct to endoscopy.

Two types of endoscopic ultrasonography in preoperative staging of gastric carcinoma

Objective: Endoscopic ultrasonography (EUS) is thought to be a useful tool for accurate preoperative staging of patients with gastric carcinomas, especially essential for determining patient selection for potentially curative resection, curative endoscopic mucosal resection (EMR), or non-curative operation. In this presentation, we report our experience with two types of EUS (the rotating sector echoendoscope [RS] and the linear sector echoendoscope [LS]) and discuss the accuracy with these EUS.

Spiral CT of the gastric carcinoma: Staging and enhancement pattern

The purpose of this study was to correlate the preoperative staging of gastric carcinoma using spiral computed tomography (CT) with pathologic staging and to correlate the enhancement pattern of advanced gastric carcinoma (AGC) on spiral CT with histological type. A total of 180 patients with gastric carcinomas confirmed at surgery underwent spiral CT. After surgery, pathologic findings were compared with CT findings. The detection rate for T1 tumors was 81.4% (57/70), and all T2–4 tumors were detected (110/110). In the T class, good correlation with pathology occurred in 47.8%. In the N class, good correlation with pathology occurred in 52.2%. The rate of understaging in the N class (31.7%) was higher than that of overstaging (16.1%) ( P<.001). In AGC, the tumor mass showed delayed enhancement, regardless of Borrmann's type. By histological pattern, good and delayed enhancement was seen in 2/3 (66.7%) with signet ring cell type, but 4/5 (80%) with mucinous type were poorly enhanced ( P=.019). Spiral CT for determining the preoperative staging of gastric carcinoma was not accurate. However, the enhancement pattern of AGC correlated with histological type.

Comparison of preoperative TN staging of gastric carcinoma by endoscopic ultrasonography with CT examination.

To assess the accuracy and limitations of endoscopic ultrasonography (EUS) in the preoperative staging of gastric carcinoma in comparison with computed tomography (CT). According to the new (1987) TN staging, 62 patients with gastric carcinomas were examined preoperatively by EUS and the results compared with those of postoperative pathological TN staging. CT of abdomen was performed before surgery for 32 of the patients. The overall accuracy of T staging was 83.9% for EUS and 28.1% for CT. For the detection of regional lymph node metastases, EUS accuracy was 79.0%, sensitivity 80.0% and specificity 87.5%, versus 50.0% accuracy for CT. The coincidence of perigastric infiltration was 90.0% for EUS and 41.2% for CT. The most frequent causes of misdiagnosis by EUS were microscopic tumor invasion and peritumorous inflammatory or fibrous changes. EUS is a reliable method for the clinical evaluation of locoregional extension of gastric cancer and more accurate than CT in the preoperative staging of gastric carcinoma.

The Usefulness of Helical CT in the Preoperative Staging of Gastric Carcinoma

The Usefulness of Helical CT in the Preoperative Staging of Gastric Carcinoma

Role of Conventional CT for Preoperative Staging of Gastric Carcinoma; A Prospective Study

Role of Conventional CT for Preoperative Staging of Gastric Carcinoma; A Prospective Study

Significance of preoperative staging of gastric carcinoma by computed tomography

Significance of preoperative staging of gastric carcinoma by computed tomography