64 multidetector-row computed tomography for preoperative evaluation of gastric cancer: histological correlation.
OBJECTIVE
To assess the accuracy of 64 multidetector-row computed tomography (MDCT) in the diagnosis and staging of gastric cancer.


METHODS
This study was approved by the institutional review board, and the patients involved gave informed consent. Forty-four patients (34 men and 10 women; mean age, 57 years) with gastric carcinoma underwent preoperative 64 MDCT (SOMATOM Sensation 64; Siemens Medical System, Forchheim, Germany; slice collimation, 0.6 mm; slice width, 5 mm; feed/rotation, 23 mm; pitch factor, 1.2; kernel, B30f; and gantry speed, 0.5 second per rotation). Gastric distension was achieved by ingestion of 8 g of effervescent granules. Scanning was performed during arterial and portal phases, as determined with bolus tracking and automated triggering technique after intravenous administration of 100 mL of contrast materials (4 mL/s). All computed tomography scans were retrospectively reviewed by 2 radiologists. Each tumor was staged according to the TNM classification system. All patients underwent surgery. Computed tomography results were compared with histological staging of tumor invasion depth and regional lymph node metastasis.


RESULTS
The accuracy of 64 MDCT for detection of gastric cancer was 90% (18/20) and 100% (24/24) in early and advanced gastric cancer, respectively, with an overall detection rate of 95% (42/44). Its accuracy for determination of tumor penetration depth was 89% (16/18) and 88% (21/24) in early and advanced gastric cancer, respectively, with an overall accuracy of 88% (37/42). Its accuracy for determination of lymph node metastasis was 90% (18/20) and 71% (17/24) in early and advanced gastric cancer, respectively, with an overall accuracy of 80% (35/44).


CONCLUSIONS
The 64 MDCT is a promising technique for the detection and preoperative staging of gastric cancer.
Yang
Dal Mo
DM
Department of Radiology, East-West Neo Medical Center, Kyung Hee University, Seoul, South Korea. dmy2988@yahoo.co.kr
Kim
Hyun Cheol
HC
Jin
Wook
W
Ryu
Chang Woo
CW
Kang
Jee Hee
JH
Park
Chul Hi
CH
Kim
Hyung Sik
HS
Jung
Dong Hae
DH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods