RSNA 2003 

Abstract Archives of the RSNA, 2003


C06-270

Efficacy of Multidetector Row CT in T-Staging of Gastric Cancer

Scientific Papers

Presented on December 1, 2003
Presented as part of C06: Gastrointestinal (Gastric Cancer: Multi-Detector Row CT)

Participants

Seishi Kumano MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: The purpose of this study was to assess the efficacy of MDCT for depth of invasion in gastric cancer. Methods and Materials: Forty-one patients with a diagnosis of gastric cancer underwent MDCT before sugery (24 men and 17 women, mean age of 68 years old). CT examination was performed using a multi-detector helical CT (LightSpeed QXi, GE Medical System). All patients were given 600 ml of tap water to drink. The patient was laid on the scanning table in a prone postion. If the lesion was in the gastric cardia or fundus, the patient was placed in the supine position for CT scanning. A total of 100ml of nonionic contrast material was injected intravenously at a rate of 3ml/s. Scan were stated 70s after initiation of the injection of intravenous contrast material. MDCT was started from the level of the dome of the right hemidiaphragm to the lower edge of stomach to include the entire liver. The detector-row configuration was 1.25 x 4 mm, the pitch was 6, and 0.6mm reconstruction interval. Based on the volumetric data obtained by MDCT, axial images of 2.5-mm section thickness at 2.5-mm intervals were printed on hard copies. MPR was also performed at the CT console using the software facilitated in the CT scanner. Oblique coronal and oblique sagittal images of the entire stomach were obtained in all patients. MPR images of 3-mm section thickness at 3-mm interval were printed on hard copies. Axial images and MPR images were evaluated by two radiologists independently. Results: Pathologically, the tumors were classified as T1 in 17 patients, T2 in 14 patients, T3 in 8 patients, and T4 in 2 patients. Correct assessment of tumor extension through the gastric wall (T stage) was 80% and 83% for the two observers, which means that 33 and 34 patients were correctly staged . Overstaging occurred in 6 patients for one observer and in 3 patients for the other, and understaging occurred in 2 patient for one observer and in 4 patients for the other. The sensitivity, specificity, and accuracy of the technique in determining the invasion of serosa were 90%, 95%, and 93% for observer A and 80%, 97%, and 93% for observer B. False negative finings occurred in one case with observer A and in 2 cases with observer B. False positive findings occurred in 2 cases with observer A and in 1 case with observer B. Conclusion: MDCT scanning of patients with gastric cancer could be an accurate tool for assessment of serosal invasion in gastric cancer. MDCT dose not require additional time or cost compared with the standard technique; therefore, it may be used in all cases of tumor staging by CT.       Questions about this event email: kumano@m.ehime-u.ac.jp

Cite This Abstract

Kumano MD, S, Efficacy of Multidetector Row CT in T-Staging of Gastric Cancer.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3107440.html