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A Journal on Surgery


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Minerva Chirurgica 2014 June;69(3):129-40

language: English

Reliability of MDCT, with MPR and hydro-CT technique, in resectability and lymphnode staging of gastric cancer

Karakoyun R. 1, Demirci E. 2, Karakoyun M. 3, Karakaş B. 1, Gündüz U. 1, Şener Z. 4, Gülenay Ş. 5, Erol B. 6, Sağtaş E. 7

1 Department of Surgery, Antalya Training and Research Hospital, Antalya, Turkey;
2 Department of Radiology, Ankara University School of Medicine, Ankara, Turkey;
3 Department of Radiology, Veni Vidi Hospital, Diyarbakır, Turkey;
4 Department of General Surgery, Diyarbakır Training and Research Hospital, Diyarbakir, Turkey;
5 Department of Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey;
6 Department of Radiology, Antalya Training and Research Hospital, Antalya, Turkey;
7 Department of Radiology, Antalya Memorial Hospital, Antalya, Turkey


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AIM: The aim of this study was to evaluate the reliability of thin-slice hydro-multidetector row computed tomography (MDCT) in assessing resectability and lymph node staging of gastric cancer.
METHODS: Sixty-one patients (37 males, 24 females; mean age 61 years) with gastric cancer, and whose surgery was planned, underwent preoperative abdominopelvic hydro-MDCT at slice thickness of 5 mm. We evaluated the tumor stage, depth of tumor invasion into the gastric wall, metastasis of lymph node, and presence/absence of distant metastases on the CT images produced with multiplanar reconstruction (MPR) and hydro-CT technique. The results were compared with pathological and surgical findings. Diagnostic accuracy was also analyzed.
RESULTS: Of 61 patients with gastric cancer, 6 (14%) were inoperable, 45 (68%) were advanced stage, and 10 (16%) were early stage gastric cancer patients. The detection rate of the primary tumor was 97% for MDCT; the overall accuracy of MDCT in the determination of the depth of invasion and serosal involvement when compared with pathological staging were 84% and 95%, respectively; the overall accuracy rate in lymph node staging was 73.5%.
CONCLUSION: MDCT can improve the accuracy of preoperative T and N staging of gastric cancer and will contribute to treatment strategies for patients with advanced stage gastric cancer.

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