title: Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US.
abstract: OBJECTIVE
  To compare the performance of helical computed tomography (CT) and endoscopic ultrasonography (US) in the preoperative staging of gastric cancer.
  
  
  METHODS
  Fifty-one consecutive patients with a primary malignant gastric tumor (stage T2-T4) were preoperatively evaluated with both helical CT and endoscopic US within 3 days. Each tumor was staged according to the TNM classification system with both modalities. All patients subsequently underwent surgery. Results of CT and endoscopic US were compared with histologic staging of tumor invasion depth and regional lymph node metastasis. For comparison of CT and endoscopic US data, the marginal homogeneity test was used, and a P value of less than.05 was determined to indicate statistical significance.
  
  
  RESULTS
  In comparison with histologic results, CT achieved correct T staging in 39 patients (76%) and correct N staging in 35 patients (70%). The corresponding results for endoscopic US achieved correct T staging in 44 patients (86%) and correct N staging in 45 patients (90%). There was no significant difference between T staging (P =.55) and N staging (P >.99). Because of challenging detection of wall layers, correct T staging was difficult for CT and endoscopic US in the differentiation of T2 and T3 lesions.
  
  
  CONCLUSIONS
  Compared with endoscopic US, helical CT focused on the stomach provides valuable results regarding T and N staging in patients with gastric cancer.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. c.habermann@uke.uni-hamburg.de
authors.forename: Christian R
authors.initials: CR
authors.lastname: Habermann
authors.forename: Florian
authors.initials: F
authors.lastname: Weiss
authors.forename: Rasmus
authors.initials: R
authors.lastname: Riecken
authors.forename: Human
authors.initials: H
authors.lastname: Honarpisheh
authors.forename: Sabine
authors.initials: S
authors.lastname: Bohnacker
authors.forename: Carsten
authors.initials: C
authors.lastname: Staedtler
authors.forename: Christoph
authors.initials: C
authors.lastname: Dieckmann
authors.forename: Volker
authors.initials: V
authors.lastname: Schoder
authors.forename: Gerhard
authors.initials: G
authors.lastname: Adam
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D019160:Endosonography; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D036542:Tomography, Spiral Computed