Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US.
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.
Habermann
Christian R
CR
Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. c.habermann@uke.uni-hamburg.de
Weiss
Florian
F
Riecken
Rasmus
R
Honarpisheh
Human
H
Bohnacker
Sabine
S
Staedtler
Carsten
C
Dieckmann
Christoph
C
Schoder
Volker
V
Adam
Gerhard
G
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