title: Prospective comparison of 3T MRI with diffusion-weighted imaging and MDCT for the preoperative TNM staging of gastric cancer.
abstract: OBJECTIVE
  To compare the diagnostic performance of 3T magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) and multidetector-row computed tomography (MDCT) for the preoperative TNM staging of gastric cancer.
  
  
  METHODS
  This prospective study was approved by our Institutional Review Board. Forty-nine consecutive patients with histologically confirmed gastric cancers underwent MDCT and 3T MRI followed by surgery. MRI without DWI, MRI with DWI, and MDCT were reviewed to determine preoperative TNM staging. Using the pathologic stages as the reference standard, the diagnostic performance of each imaging modality was compared.
  
  
  RESULTS
  Diagnostic accuracies of MRI with DWI, MRI without DWI, and MDCT did not show a significant difference (≤T2 vs. ≥T3: 85.1%, 78.7%, and 80.9%; ≤T3 vs. T4: 76.6%, 74.5%, and 72.3%; N-negative vs. N-positive: 76.6%, 66.0%, and 63.8%; M0 vs. M1: all 95.9%, respectively) (P > 0.05). For N staging, MRI with DWI demonstrated higher sensitivity but lower specificity (86.7% and 58.8%, respectively) than MRI without DWI (50.0% and 94.1%) or MDCT (43.3% and 100%) (P < 0.05).
  
  
  CONCLUSIONS
  The diagnostic accuracy of 3T MRI is comparable to that of MDCT for the preoperative TNM staging of gastric cancer, and for assessing LN metastasis, the addition of DWI to conventional MRI may increase the sensitivity.
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Ijin
authors.initials: I
authors.lastname: Joo
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Jung Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Cheong-Il
authors.initials: CI
authors.lastname: Shin
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
authors.forename: Byung Ihn
authors.initials: BI
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013270:Stomach / Q000000981:diagnostic imaging / Q000473:pathology; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*
chemical_list: D003287:Contrast Media
keywords: MDCT; MRI; gastric cancer; staging