title: Is endoscopic ultrasonography still the modality of choice in preoperative staging of gastric cancer?
abstract: The treatment option for gastric cancer is usually based on preoperative staging by imaging modalities. Endoscopic ultrasonography (EUS) and computed tomography (CT) have been used as the diagnostic modality of choice in preoperative staging of gastric cancer. Magnetic resonance imaging (MRI) has been employed in several studies, and ((18)F) 2-Fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) has emerged as a new promising imaging modality. The purpose of this article is to provide summarized information on preoperative staging using EUS, multi-detector row CT (MDCT), MRI and PET for gastric cancer. In T staging, both EUS and MDCT show high accuracy. MRI seemed to have better performance, but the number of MRI studies is limited. FDG-PET is not able to properly evaluate the depth of invasion. In N staging, the diagnostic accuracy of EUS, MDCT and MRI is not sufficient. In preoperative M staging, MDCT and FDG-PET showed similar diagnostic accuracies. FDG-PET/CT fusion could be expected to show better performance in the future. Physicians should keep in mind that each diagnostic modality has advantages and limitations and choose an appropriate diagnostic strategy tailored for each patient.
authors.affiliation: Sung Wook Hwang, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Hwang
authors.affiliation: Sung Wook Hwang, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
mesh_terms: D019160:Endosonography; D006801:Humans; D008279:Magnetic Resonance Imaging; D061330:Multidetector Computed Tomography; D064847:Multimodal Imaging; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery
keywords: Computed tomography; Endoscopic ultrasonography; Gastric cancer; Magnetic resonance imaging; Positron emission tomography