title: Accuracy of multidetector-row CT in diagnosing lymph node metastasis in patients with gastric cancer.
abstract: OBJECTIVE
  The purpose of this study was to determine the optimal cut-off value of lymph node size for diagnosing metastasis in gastric cancer with multidetector-row computed tomography (MDCT) after categorizing perigastric lymph nodes into three regions.
  
  
  METHODS
  The study included 90 gastric cancer patients who underwent gastrectomy. The long-axis diameter (LAD) and short-axis diameter (SAD) of all visualized lymph nodes were measured with transverse MDCT images. The locations of lymph nodes were categorized into three regions: lesser curvature, greater curvature, and suprapancreatic. The diagnostic value of lymph node metastasis was assessed with receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  The area under the curve was larger for SAD than LAD in all groups. The optimal cut-off values of SAD were determined as follows: overall, 9 mm; differentiated type, 9 mm; undifferentiated type, 8 mm; lesser curvature region, 7 mm; greater curvature region, 6 mm; and suprapancreatic region, 9 mm. The diagnostic accuracies for lymph node metastasis using individual cut-off values were 71.1% based on histological type and 76.6% based on region of lymph node location.
  
  
  CONCLUSIONS
  The diagnostic accuracy of lymph node metastasis in gastric cancer was improved by using individual cut-off values for each lymph node region.
  
  
  CONCLUSIONS
  • Multidetector-row computed tomography is widely used to predict pathological nodal status. • An optimal cut-off value of lymph node size has not been determined. • Cut-off values were assessed according to histology and nodal location. • The optimal cut-off values differed based on histology and nodal location. • Diagnostic accuracy was improved by using individual cut-off values for each region.
authors.affiliation: Department of Gastroenterological Surgery, Osaka University, Graduate School of Medicine, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Saito
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kurokawa
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyata
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Nakajima
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods / Q000592:standards; D009367:Neoplasm Staging / Q000592:standards; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery
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