title: Tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography: association with N categories.
abstract: OBJECTIVE
  To determine whether the gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict the presence of regional lymph node metastasis and could determine N categories.
  
  
  METHODS
  A total of 202 consecutive patients with gastric adenocarcinoma who had undergone gastrectomy 1 week after contrast-enhanced multidetector computed tomography were retrospectively identified. The gross tumor volume was evaluated on multidetector computed tomography images. Univariate and multivariate analyses were performed to determine whether the gross tumor volume could predict regional lymph node metastasis, and the Mann-Whitney U test was performed to compare the gross tumor volume among N categories. Additionally, a receiver operating characteristic analysis was performed to identify the accuracy of the gross tumor volume in differentiating N categories.
  
  
  RESULTS
  The gross tumor volume could predict regional lymph node metastasis (p<0.0001) in the univariate analysis, and the multivariate analyses indicated that the gross tumor volume was an independent risk factor for regional lymph node metastasis (p=0.005, odds ratio=1.364). The Mann-Whitney U test showed that the gross tumor volume could distinguish N0 from the N1-N3 categories, N0-N1 from N2-N3, and N0-N2 from N3 (all p<0.0001). In the T1-T4a categories, the gross tumor volume could differentiate N0 from the N1-N3 categories (cutoff, 12.3 cm3), N0-N1 from N2-N3 (cutoff, 16.6 cm3), and N0-N2 from N3 (cutoff, 24.6 cm3). In the T4a category, the gross tumor volume could differentiate N0 from the N1-N3 categories (cutoff, 15.8 cm3), N0-N1 from N2-N3 (cutoff, 17.8 cm3), and N0-N2 from N3 (cutoff, 24 cm3).
  
  
  CONCLUSIONS
  The gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict regional lymph node metastasis and N categories.
authors.affiliation: Department of Radiology, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Chen
authors.affiliation: Department of Out-patient, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Jun-Ru
authors.initials: JR
authors.lastname: Li
authors.affiliation: Department of Out-patient, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Zhen-Lin
authors.initials: ZL
authors.lastname: Li
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan, China.
authors.forename: Tian-Wu
authors.initials: TW
authors.lastname: Chen
authors.affiliation: Department of Radiology, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Pu
authors.affiliation: Department of Radiology, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China.
authors.forename: Long-Lin
authors.initials: LL
authors.lastname: Yin
authors.affiliation: Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.
authors.forename: Guo-Hui
authors.initials: GH
authors.lastname: Xu
authors.affiliation: Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.
authors.forename: Zhen-Wen
authors.initials: ZW
authors.lastname: Li
authors.affiliation: Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Reng
authors.affiliation: Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhou
authors.affiliation: Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.
authors.forename: Zhu-Zhong
authors.initials: ZZ
authors.lastname: Cheng
authors.affiliation: Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Cao
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D015588:Observer Variation; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D047368:Tumor Burden; D055815:Young Adult