title: Diffusion MRI on lymph node staging of gastric adenocarcinoma.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the accuracy of diffusion weighted magnetic resonance imaging (MRI) in preoperative assessment of metastatic lymph nodes of gastric cancer.
  
  
  METHODS
  A total of 23 gastric cancer patients with a mean age of 59.4±10.9 years were analyzed. Lymph nodes were grouped as perigastric lesser curvature (Group Ia), perigastric greater curvature (Group Ib), D1+/D2 lymph nodes (Group II). Identification of histologically metastatic lymph nodes by diffusion weighted MRI was regarded as the main outcome.
  
  
  RESULTS
  A total of 1,056 lymph nodes including 180 histologically proven metastatic lymph nodes were dissected. Although diffusion weighted MRI could identify the metastatic lymph nodes in 18 out of 23 patients (77.8%), only 69 of total 1,056 nodes (6.53%), either metastatic or non-metastatic, could be detected. There was no correlation between histopathology and diffusion weighted MRI with regard to lymph node groups (P>0.05 for all). Overall accuracy was calculated as 69.56, 65.21 and 52.17 for Groups II, Ib and Ia lymph nodes, respectively. Apparent diffusion coefficient (ADC) values could not be helpful to differentiate metastatic lymph nodes (P=0.673).
  
  
  CONCLUSIONS
  Diffusion weighted MRI has low accuracy to detect or to differentiate metastatic and non-metastatic lymph nodes based on their ADC values in gastric cancer.
authors.affiliation: 1 Department of General Surgery, 2 Department of Radiology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey ; 3 Department of General Surgery, Fatih University Faculty of Medicine, Fatih, Istanbul 34500, Turkey ; 4 Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Hasbahceci
authors.affiliation: 1 Department of General Surgery, 2 Department of Radiology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey ; 3 Department of General Surgery, Fatih University Faculty of Medicine, Fatih, Istanbul 34500, Turkey ; 4 Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Akcakaya
authors.affiliation: 1 Department of General Surgery, 2 Department of Radiology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey ; 3 Department of General Surgery, Fatih University Faculty of Medicine, Fatih, Istanbul 34500, Turkey ; 4 Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Naim
authors.initials: N
authors.lastname: Memmi
authors.affiliation: 1 Department of General Surgery, 2 Department of Radiology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey ; 3 Department of General Surgery, Fatih University Faculty of Medicine, Fatih, Istanbul 34500, Turkey ; 4 Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Ihsan
authors.initials: I
authors.lastname: Turkmen
authors.affiliation: 1 Department of General Surgery, 2 Department of Radiology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey ; 3 Department of General Surgery, Fatih University Faculty of Medicine, Fatih, Istanbul 34500, Turkey ; 4 Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Cipe
authors.affiliation: 1 Department of General Surgery, 2 Department of Radiology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey ; 3 Department of General Surgery, Fatih University Faculty of Medicine, Fatih, Istanbul 34500, Turkey ; 4 Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Pelin
authors.initials: P
authors.lastname: Yildiz
authors.affiliation: 1 Department of General Surgery, 2 Department of Radiology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey ; 3 Department of General Surgery, Fatih University Faculty of Medicine, Fatih, Istanbul 34500, Turkey ; 4 Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Dilek Sema
authors.initials: DS
authors.lastname: Arici
authors.affiliation: 1 Department of General Surgery, 2 Department of Radiology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey ; 3 Department of General Surgery, Fatih University Faculty of Medicine, Fatih, Istanbul 34500, Turkey ; 4 Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Fatih, Istanbul 34093, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Muslumanoglu
keywords: Gastric cancer; apparent diffusion coefficient (ADC); diffusion weighted imaging; lymph nodes; magnetic resonance imaging (MRI)