title: CT and endoscopic ultrasound in comparison to endoluminal MRI: preliminary results in staging gastric carcinoma.
abstract: OBJECTIVE
  To prospectively compare diagnostic parameters of a newly developed endoluminal MRI (endo-MRI) concept with endoscopic ultrasound (EUS) and hydro-computer tomography (Hydro-CT) in T-staging of gastric carcinoma on one patient collective.
  
  
  METHODS
  28 consecutive patients (11 females, 17 males, age range 46-87 years, median 67 years) referred for surgery due to a gastric malignancy were included. Preoperative staging by EUS was performed in 14 cases and by Hydro-CT in 14 cases within a time frame of 2 weeks. Ex vivo endo-MRI examination of gastric specimens was performed directly after gastrectomy within a time interval of 2-3h. EUS data were acquired from the clinical setting whereas Hydro-CT and endo-MRI data were evaluated in blinded fashion by two experienced radiologists and one surgeon well experienced in EUS on gastric carcinomas.
  
  
  RESULTS
  Histopathology resulted in 4 pT1, 17 pT2, 3 pT3 and 2 pT4 carcinomas with 2 gastric lymphomas which were excluded. Overall accuracy for endo-MRI was 75% for T-Staging of the 26 carcinomas. EUS achieved 42.9% accuracy; endo-MRI in this subgroup was accurate in 71.4%. Hydro-CT was correct in 28.6%, accuracy for endo-MRI in this subgroup was 71.4%.
  
  
  CONCLUSIONS
  The direct comparison of all three modalities on one patient collective shows that endo-MRI is able to achieve adequate staging results in comparison with clinically accepted methods like EUS and Hydro-CT in classifying the extent of tumor invasion into the gastric wall. However the comparison is limited as we compared in vivo routine clinical data with experimental ex vivo data. Future investigations need to show if the potential of endo-MRI can be transferred into a clinical in vivo setting.
authors.affiliation: Department of Diagnostic Radiology, University Hospital, 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: Markus
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: D000368:Aged; D000369:Aged, 80 and over; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000379:methods*