title: Special interest radiology improves the perceived preoperative stage of gastric cancer.
abstract: OBJECTIVE
  The aim of this study was to compare the accuracy of spiral computed tomography (CT) performed by a specialist radiologist within a multi disciplinary team (MDT) framework with that of radiologists working outside of this framework.
  
  
  METHODS
  One hundred and ten patients [median age 70 (35-86)yr, 71m] underwent either a preoperative CT performed by the MDT specialist consultant radiologist (n=60) or a CT performed by one of 13 other consultant radiologists (n=50). The strength of the agreement between the CT stage and the histopathological stage was determined by the weighted Kappa statistic (Kw).
  
  
  RESULTS
  Sensitivity for T, N and M stage were 64%, 65% and 25% for MDT specialist CT, compared with 24%, 24% and 5% for control CT. Specificity for T, N and M stage were 68%, 59% and 95% for MDT specialist CT compared with 79%, 94% and 93% for control CT. Kw for T, N and M stage were 0.314, 0.350 and 0.255 for MDT specialist CT compared with 0.088, 0.102 and -0.019 for control CT. Unsuspected metastases were found in 12 patients staged by MDT specialist CT compared with 19 patients staged by control CT (Chi2=4.366, df=1,p =0.037).
  
  
  CONCLUSIONS
  Improved patient selection for surgery should maximize use of limited resource.
authors.affiliation: Department of Surgery, Royal Gwent Hospital, Newport, South Wales NP20 2UB, United Kingdom.
authors.forename: J D
authors.initials: JD
authors.lastname: Barry
authors.forename: P
authors.initials: P
authors.lastname: Edwards
authors.forename: W G
authors.initials: WG
authors.lastname: Lewis
authors.forename: D
authors.initials: D
authors.lastname: Dhariwal
authors.forename: G V
authors.initials: GV
authors.lastname: Thomas
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010348:Patient Care Team; D018579:Patient Selection; D011237:Predictive Value of Tests; D011871:Radiology / Q000458:organization & administration*; D012680:Sensitivity and Specificity; D013038:Specialization; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D036542:Tomography, Spiral Computed