title: Detection of lymph-node metastases in patients with gastric carcinoma: comparison of three MR imaging pulse sequences.
abstract: BACKGROUND
  To compare the diagnostic accuracy of magnetic resonance (MR) images obtained with three different pulse sequences for lymph-node metastases in patients with gastric cancer.
  
  
  METHODS
  T1-weighted spin-echo (SE), breath-hold T2-weighted fast SE, and triphasic gadolinium-enhanced dynamic gradient-recall-echo (GRE) MR images obtained in 16 patients with gastric carcinoma were retrospectively reviewed. Regional lymph nodes were assigned to four different groups, and image review was conducted on a lymph-node group-by-group basis; 64 lymph-node groups were reviewed by two radiologists. Relative sensitivity, specificity, and accuracy were determined based on the findings with definitive surgery and follow-up imaging. Diagnostic accuracy was determined by means of receiver-operating-characteristic (ROC) analysis.
  
  
  RESULTS
  Relative sensitivities for lymph-node metastases with T1-weighted SE, breath-hold T2-weighted fast SE, and dynamic GRE images were 61%, 94%, and 59%, respectively. Relative sensitivity with breath-hold T2-weighted fast SE images was significantly greater than that with T1-weighted SE (p < 0.05) and dynamic GRE (p < 0.05) images. Diagnostic accuracy determined by ROC analysis was marginally higher with breath-hold T2-weighted fast SE (area under ROC curve [Az] = 0.87) than with T1-weighted SE (Az = 0.78, p = 0.08) and dynamic GRE (Az = 0.79, p = 0.12) images.
  
  
  CONCLUSIONS
  Breath-hold T2-weighted fast SE sequence is useful in the detection of regional lymph-node metastases in patients with gastric carcinoma.
authors.affiliation: Second Department of Surgery, Gifu University School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kato
authors.forename: S
authors.initials: S
authors.lastname: Saji
authors.forename: M
authors.initials: M
authors.lastname: Kanematsu
authors.forename: D
authors.initials: D
authors.lastname: Fukada
authors.forename: K
authors.initials: K
authors.lastname: Miya
authors.forename: T
authors.initials: T
authors.lastname: Umemoto
authors.forename: K
authors.initials: K
authors.lastname: Kunieda
authors.forename: Y
authors.initials: Y
authors.lastname: Sugiyama
authors.forename: H
authors.initials: H
authors.lastname: Takao
authors.forename: Y
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Takagi
authors.forename: H
authors.initials: H
authors.lastname: Kondo
authors.forename: H
authors.initials: H
authors.lastname: Hoshi
mesh_terms: D000005:Abdomen; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000601:surgery