Role of Multidetector CT in Staging of Gastric Carcinoma ()
ABSTRACT
Background: Radiology plays an essential role in the diagnosis, staging and
surveillance of oncology patients. CT is the most sensitive imaging modality in
the workup of these patients. Aim of the Study: The aim of this work is
to detect the role of MDCT (multidetector computed tomography) in the preoperative
investigation of gastric adenocarcinoma patients according to TNM staging. Patients
and Methods: This is a prospective study enrolling 20 patients who had
histologically proven adenocarcinoma based upon an upper gastrointestinal
endoscopic biopsy for MDCT staging of gastric carcinoma during the period from
June 2016 to June 2017. The MSCT data were correlated and compared with the histopathological
results. The study was conducted in the Radiology Department of Assiut University
Hospital using 64-MDCT (Toshiba Aquilion). Results: According to our study results, the
sensitivity of determining T1 stage on CT scan can’t be detected as there was
only 1 case pathologically proved T1 and overstaged as T2 by MSCT; however,
accuracy and specificity are quite high, which was 95% and 100% respectively. For
T2 stage tumors (25.0% of cases), accuracy is 95%, sensitivity—100%, and
specificity—93.7%. According to our results the accuracy and sensitivity of T3
staging are 75% and 100%, while those of T4 stage were 75% and 44.4%
respectively. Tumor was correctly staged in 14 of 20 patients (the valid T
staging rate was 70.0%). Tumor was under-staged in 5 of 20 patients (25.0%)
(staged as T3, but pathologically proven to be T4a). As regards N staging accuracy
found results for N0 (62.5%), N2 (87.5%) and N3 (75%), while N1 accuracy
recorded 37.5%. As regards the nodal staging sensitivity which had a range from
(0% for N4) to (66% for N2) this wide range of sensitivity demonstrates the
problem of CT in nodal staging. As regards sensitivity of M0, accuracy was 100%
and 85% respectively. While that of M1 was (62.5%) and (85%) respectively. Conclusion: MSCT can be the first choice for the preoperative evaluation of patients
with gastric carcinoma. It presents excellent accuracy in the staging of tumor
invasion depth (T) and in the staging of metastatic neoplastic disease (M).
Despite the good accuracy in the staging of patients without lymph node disease
(N0), the method presents limitations in the staging of lymph node involvement.
Share and Cite:
Emam, H. , Moussa, E. , Abouelmaged, M. and Ibrahim, M. (2019) Role of Multidetector CT in Staging of Gastric Carcinoma.
Journal of Cancer Therapy,
10, 565-579. doi:
10.4236/jct.2019.107046.