Preoperative staging of gastric carcinoma with multidetector spiral CT.
OBJECTIVE
To assess the accuracy of Multidetector computed tomography (MDCT) in the preoperative staging of gastric cancer.


METHODS
Between March 2002 and October 2002, 27 patents with histologically proven gastric adenocarcinoma underwent MDCT. Unenhanced and contrast-enhanced CT scans were obtained after the oral administration of 400-600 ml of water for gastric wall distension. Biphasic enhanced scans were performed after the automatic injection of 2ml/kg of contrast agent at a flow rate of 3.5 ml/sec with a scan delay of 35 and 70 sec. The images were evaluated for: lesion morphology, degree of wall infiltration, presence of locoregional lymphadenopathies and distant metastases. Based on the findings, a TCMD staging system was established according to the criteria reported in the literature. All the patients underwent surgery, and the preoperative MDCT staging was evaluated against the pathology findings.


RESULTS
MDCT staging was correct in 17/27 patients (62.9%). The T parameter was correctly assessed in 24/27 cases (88.9%), whereas it was understaged in 1 case (3.7%) (T1 stage at CT vs T2 at surgery) and overstaged in 2 cases (7.4%) (T3 vs T2). The N parameter was correctly evaluated in 19/27 patients (70.4%), understaged in 6/27 (22.2%) and overstaged in 2/27 (7.4%).


CONCLUSIONS
MDCT may be proposed for the staging of gastric carcinomas and, although accuracy in N staging remains low in comparison to single-detector spiral CT, it provides a larger amount of diagnostic information.
Stabile Ianora
Amato Antonio
AA
Di.M.I.M.P., Sezione di Diagnostica per Immagini, Università degli Studi di Bari, Policlinico, Bari, Italy. a.stabile@radiologia.uniba.it
Pedote
Pasquale
P
Scardapane
Arnaldo
A
Memeo
Maurizio
M
Rotondo
Antonio
A
Angelelli
Giuseppe
G
D000230:Adenocarcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D036542:Tomography, Spiral Computed / Q000379:methods*