title: Preoperative T staging of gastric cancer: comparison of diffusion- and T2-weighted magnetic resonance imaging.
abstract: OBJECTIVE
  The objective of our study was to assess the clinical feasibility of diffusion-weighted (DW) magnetic resonance (MR) imaging in preoperative T staging of gastric cancer prospectively.
  
  
  METHODS
  Forty-five patients underwent axial T2-weighted (T2W) and DW (b, 0 and 1000 seconds/mm) MR imaging. Two radiologists interpreted the images for detection and staging of the tumors independently. The McNemar test was used to check differences in diagnostic accuracy with the reference of postoperative histopathological results.
  
  
  RESULTS
  Diffusion-weighted and T2W images detected 44 and 42 of 45 histologically confirmed lesions, respectively. Furthermore, DW images detected 11 of 12 pT1 lesions compared to 9 of 12 lesions by T2W images. The staging accuracy of advanced gastric cancer (≥pT2) in DW imaging is significantly higher than that in T2W imaging (87.9% and 69.7%, respectively; P < 0.05).
  
  
  CONCLUSIONS
  Diffusion-weighted is superior to T2W imaging in detection of early gastric cancers (pT1) and staging advanced cancers (≥pT2).
authors.affiliation: From the *Departments of Radiology, †Gastrointestinal Surgery, and ‡Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China; and §Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.
authors.forename: Song
authors.initials: S
authors.lastname: Liu
authors.forename: Jian
authors.initials: J
authors.lastname: He
authors.forename: Wenxian
authors.initials: W
authors.lastname: Guan
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Zhang
authors.forename: Hui
authors.initials: H
authors.lastname: Mao
authors.forename: Haiping
authors.initials: H
authors.lastname: Yu
authors.forename: Zhengyang
authors.initials: Z
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015588:Observer Variation; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000473:pathology*