T-staging of gastric cancer of air-filling multidetector-row CT: comparison with hydro-multidetector-row CT.
OBJECTIVE
The purpose of this study was to evaluate the accuracy of T-staging of gastric cancer by air-filling multidetector-row CT (air-MDCT) compared with water-filling MDCT (hydro-MDCT).


METHODS
One hundred fifteen patients with histologically diagnosed gastric cancer were included in this study. Fifty-eight patients underwent air-MDCT, and the remaining 57 had hydro-MDCT using a 64-channel scanner. Based on the volumetric data of contrast-enhanced MDCT obtained about 75 s after intravenously injecting 525 mg iodine per kilogram patients weight (525 mgI/kg) nonionic contrast material at the rate of 2 ml/s, oblique coronal and oblique sagittal multi-planar reformatted images perpendicular to the stomach wall, including the tumor, were reconstructed on a workstation. Mural invasion of gastric cancer into the gastric wall, as visualized by CT, was classified according to the TNM classification, and the results of T-staging by MDCT were compared with those by pathologic analysis after surgery.


RESULTS
Correct assessment of T-staging by air-CT was achieved in 48 of 58 patients (83%), and that by hydro-MDCT was 49 of 57 patients (86%). The sensitivity, specificity, and accuracy of the technique in determining the invasion of serosa were 88%, 93%, and 91% for air-CT and 83%, 95%, and 91% for hydro-CT. There were no significant differences between hydro-MDCT and air-MDCT in sensitivity (P=0.73), specificity (P=0.71) and accuracy (P=0.98).


CONCLUSIONS
Air-MDCT is a very valuable tool in T-staging of gastric cancer as well as hydro-MDCT.
Department of Radiology, Kinki University School of Medicine, Osakasayama, Osaka 589-8511, Japan. kumano@radiol.med.kindai.ac.jp
Seishi
S
Kumano
Masahiro
M
Okada
Taro
T
Shimono
Masatomo
M
Kuwabara
Yukinobu
Y
Yagyu
Izumi
I
Imaoka
Ryuichiro
R
Ashikaga
Kazunari
K
Ishii
Takamichi
T
Murakami
D000328:Adult; D000368:Aged; D000388:Air; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media