MRI in staging advanced gastric cancer: is it useful compared with spiral CT?
OBJECTIVE
During the last decade, rapid progress has been made in MR technology. Our objective was to evaluate the role of MRI in staging advanced gastric cancer (AGC; gastric cancer invading the muscularis propria) and to compare it with that of spiral CT.


METHODS
We prospectively performed both MR and CT examinations on 26 patients with AGC proven by endoscopic biopsy. Contrast-enhanced CT and nonenhanced MRI with a 1.0 T scanner using FLASH, HASTE, and true-FISP sequences were obtained in each patient after injection of antiperistaltic drug and ingestion of 1 L of tap water. Fifty-two sets of CT and MR images were analyzed by two radiologists in consensus without any information from other images. T and N staging of AGC was determined according to the TNM classification. All patients underwent surgery within 1 week after both examinations. Diagnostic accuracy of each staging of AGC on CT or MRI was evaluated by comparison with the pathologic results.


RESULTS
MRI was slightly superior to CT in T staging (81 vs. 73%, respectively; p < 0.05). Although MRI had a tendency to overstage the pathologic T2 cancer, positive predictability of T2 stage and sensitivity of T3 stage were high (100%, respectively). Regarding the N staging, CT was slightly superior to MRI (73 vs. 65%; p > 0.05). However, both CT and MRI demonstrated the tendency of understaging in N staging.


CONCLUSIONS
Although MRI was superior to spiral CT in T staging, MRI cannot completely replace spiral CT in staging AGC because of its limitation in N staging.
Kim
A Y
AY
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Korea.
Han
J K
JK
Seong
C K
CK
Kim
T K
TK
Choi
B I
BI
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000379:methods