title: Preoperative multidetector-row computed tomography scan staging for lymphatic gastric cancer spread.
abstract: BACKGROUND
  Multidetector-row computed tomography (MDCT) is commonly used to stage patients with gastric cancer, even though the technique often shows low specificity for lymph-node involvement.
  
  
  METHODS
  In this study, 111 patients with gastric cancer who consecutively underwent MDCT scan followed by radical surgical treatment at our hospital were retrospectively evaluated.
  
  
  RESULTS
  In total, 3632 lymph nodes from 643 lymphatic stations were studied and then correlated with radiological features. Lymph-node size was not always associated with infiltration. Of the 261 lymph-node stations that were not radiologically detected, 60 (22.9%) were infiltrated. There were 108 stations with lymph nodes larger than 10 mm seen on MDCT, of which 67 (62%) had lymphatic invasion. The sensitivity was 32.6%, specificity 90.6%, positive predictive value 62.0%, negative predictive value 74.2%, and accuracy 72.1%. When three lymph nodes, at least one of which was larger than 10 mm, were detected in the same station, infiltration was confirmed with 99% specificity in 93.8% of patients. Moreover, all of the 13 patients in whom three lymph nodes larger than 10 mm were detected in different neighboring stations had lymphatic invasion.
  
  
  CONCLUSIONS
  Although presence of lymph nodes greater than 10 mm in size is not, in itself, sufficient to confirm lymphatic invasion, nodal involvement can be hypothesized when associated images are detected by MDCT.
authors.affiliation: Department of General Surgery, Morgagni-Pierantoni Hospital, Via Forlanini 34, Forlì, Italy. p.morgagni@ausl.fo.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Morgagni
authors.forename: Enrico
authors.initials: E
authors.lastname: Petrella
authors.forename: Barbara
authors.initials: B
authors.lastname: Basile
authors.forename: Alberto
authors.initials: A
authors.lastname: Mami
authors.forename: Augusto
authors.initials: A
authors.lastname: Soro
authors.forename: Andrea
authors.initials: A
authors.lastname: Gardini
authors.forename: Filippo
authors.initials: F
authors.lastname: Calzolari
authors.forename: Domenico
authors.initials: D
authors.lastname: Garcea
authors.forename: Mauro
authors.initials: M
authors.lastname: Bertocco
mesh_terms: D002086:Butylscopolammonium Bromide; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods; D018727:Muscarinic Antagonists; D009367:Neoplasm Staging; D057234:Preoperative Period; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery
chemical_list: D018727:Muscarinic Antagonists; D002086:Butylscopolammonium Bromide