title: The utility of MRI for pre-operative T and N staging of gastric carcinoma: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To perform a meta-analysis and literature review regarding the diagnostic accuracy of MRI for pre-operative tumour depth invasion (T) and regional lymph node invasion (N) staging of gastric carcinoma (GC).
  
  
  METHODS
  Articles were identified through systematic search of Medline, PubMed, Cochrane Library, Web of Science, Springerlink and several Chinese databases. The study quality was assessed by the quality assessment for studies of diagnostic accuracy. 2 reviewers independently extracted and assessed the data from 11 eligible studies. A meta-analysis was then carried out. Subgroup and sensitivity analyses were also performed.
  
  
  RESULTS
  11 studies (439 patients) were finally included in the current review. Among these studies, the significant evidence of heterogeneity was only discovered for specificity in T4 stage (I(2) = 59.8%). Pooled sensitivity and specificity of MRI to diagnose T stage tumour (T3-4 vs T1-2) were 0.93 [95% confidence interval (CI), 0.89-0.96] and 0.91 (95% CI, 0.87-0.95), respectively. Pooled estimates of sensitivity and specificity of MRI to diagnose N stage tumour (N0 vs N+) were 0.86 (95% CI, 0.80-0.92) and 0.67 (95% CI, 0.54-0.79), respectively. Subgroup analyses showed that diffusion-weighted imaging was more helpful for T staging.
  
  
  CONCLUSIONS
  The present systematic review suggests that MRI has a good diagnostic accuracy for pre-operative T staging of GC and should be widely used in clinical work. However, the ability for N staging is relatively poor on MRI.
  
  
  CONCLUSIONS
  In the pre-operative staging of GC, MRI was a useful tool and may enhance accuracy for the T staging of advanced GC.
authors: Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
authors: Z
authors: http://orcid.org/0000-0002-8672-0935
authors: Z
authors: Huang
authors: D H
authors: http://orcid.org/0000-0003-0775-6719
authors: DH
authors: Xie
authors: L
authors: L
authors: Guo
authors: C H
authors: CH
authors: Hu
authors: X
authors: X
authors: Fang
authors: Q
authors: Q
authors: Meng
authors: X X
authors: XX
authors: Ping
authors: Z W
authors: ZW
authors: Lu
mesh_terms: D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D057234:Preoperative Period; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery