Preoperative Staging of Gastric Cancer Using Computed Tomography and Its Correlation with Histopathology with Emphasis on Multi-planar Reformations and Virtual Gastroscopy

Background Gastric cancer is the fifth most common cancer in the world. Preoperative staging of gastric cancer has assumed pivotal role in deciding appropriate management of gastric cancer with multi-detector computed tomography (MDCT) using hydro- and gaseous distension of stomach superseding endos...

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Bibliographic Details
Published in:Journal of gastrointestinal cancer 2021-06, Vol.52 (2), p.606-615
Main Authors: Wani, Abdul Haseeb, Parry, Arshed Hussain, Feroz, Imza, Choh, Naseer Ahmad
Format: Article
Language:English
Subjects:
Cancer Research
Gastroenterology
Internal Medicine
Medicine
Medicine & Public Health
Oncology
Original Research
Radiotherapy
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Summary:Background Gastric cancer is the fifth most common cancer in the world. Preoperative staging of gastric cancer has assumed pivotal role in deciding appropriate management of gastric cancer with multi-detector computed tomography (MDCT) using hydro- and gaseous distension of stomach superseding endoscopic ultrasound in tumor (T) and nodal (N) staging. We undertook this study to evaluate the diagnostic accuracy of MDCT in the T and N staging of gastric cancer with an attempt to differentiate between early and advanced gastric carcinomas. Methods A total of 160 patients with endoscopically diagnosed and biopsy-proven gastric cancer were subjected to MDCT after adequate gaseous and hydro-distention of stomach. Multi-planar reformatted (MPR) as well as virtual gastroscopy images were also obtained. Gastric lesions were categorized into T1 to T4 stages with N staging from N0 to N3. Preoperative CT findings were correlated with histopathological findings. Results Overall diagnostic accuracy of T staging in our study was 82.5% (132/160) with an accuracy of 75% (120/160) for N staging. The diagnostic accuracy of CT for early gastric carcinoma in our study was 93.75% with high specificity of 96% but low sensitivity of 66.7%. Conclusion MDCT using gaseous and hydro-distension of stomach is an excellent modality for near accurate preoperative T staging of gastric cancer. However, CT has a limited role in the N staging of gastric cancer. This study also suggested that the combined use of virtual gastroscopy and MPR images helps in better detection of early gastric cancers.
ISSN:1941-6628
1941-6636
DOI:10.1007/s12029-020-00436-6