ORIGINAL ARTICLES   

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

Copyright © 2014 EDIZIONI MINERVA MEDICA

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

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.