Advanced gastric cancer and perfusion imaging using a multidetector row computed tomography: correlation with prognostic determinants.
OBJECTIVE
To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases.


METHODS
A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5.


RESULTS
The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p = 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05).


CONCLUSIONS
The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.
Zhang
Huan
H
Department of Radiology, Ruijin Hospital, Shanghai, China. huanzhangy@yahoo.com
Pan
Zilai
Z
Du
Lianjun
L
Yan
Chao
C
Ding
Bei
B
Song
Qi
Q
Ling
Huawei
H
Chen
Kemin
K
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012039:Regional Blood Flow; D013274:Stomach Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed