title: New coil concept for endoluminal MR imaging: initial results in staging of gastric carcinoma in correlation with histopathology.
abstract: Our aim was to conduct a prospective study to evaluate staging accuracy of a new coil concept for endoluminal magnetic resonance imaging (MRI) on ex vivo gastric carcinomas. Twenty-eight consecutive patients referred to surgery with a clinically proven primary gastric malignancy were included. Surgical specimens were examined with a foldable and self-expanding loop coil (8-cm diameter) at 1.5 Tesla immediately after total gastrectomy. T1- and T2-weighted and opposed-phase sequences (axial, frontal sections; 3- to 4-mm slice thickness) were acquired. Investigators blinded to any patient information analyzed signal intensity of normal gastric wall, gastric tumor, and lymph nodes. Findings were compared with histopathological staging. On surgical specimens, 2-5 gastric wall layers could be visualized. All gastric tumors (26 carcinomas, two lymphomas) were identified on endoluminal MR data (100%). Overall accuracy for T staging was 75% (18/24); sensitivity to detect serosal involvement was 80% and specificity 89%. N staging correlated in 58% (14/24) with histopathology (N+ versus N-). The endoluminal coil concept is feasible and applicable for an ex vivo setting. Endoluminal MR data provided sufficient detail for gastric wall layer differentiation, and therefore, identification of T stages in gastric carcinoma is possible. Further investigations in in vivo settings should explore the potential of our coil concept for endoluminal MR imaging.
authors.affiliation: Department of Diagnostic Radiology, Ruprecht-Karls University, Heidelberg, Germany. tobias.heye@med.uni-heidelberg.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Heye
authors.forename: Christian
authors.initials: C
authors.lastname: Kuntz
authors.forename: Marcus
authors.initials: M
authors.lastname: Düx
authors.forename: Jens
authors.initials: J
authors.lastname: Encke
authors.forename: Moritz
authors.initials: M
authors.lastname: Palmowski
authors.forename: Frank
authors.initials: F
authors.lastname: Autschbach
authors.forename: Frank
authors.initials: F
authors.lastname: Volke
authors.forename: Guenter Werner
authors.initials: GW
authors.lastname: Kauffmann
authors.forename: Lars
authors.initials: L
authors.lastname: Grenacher
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005743:Gastrectomy; D005858:Germany; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D018198:Mixed Tumor, Malignant / Q000175:diagnosis / Q000601:surgery; D009367:Neoplasm Staging; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D047368:Tumor Burden