Skip to main content
Erschienen in: European Radiology 2/2018

04.08.2017 | Gastrointestinal

CT Perfusion evaluation of gastric cancer: correlation with histologic type

verfasst von: Dong Ho Lee, Se Hyung Kim, Ijin Joo, Joon Koo Han

Erschienen in: European Radiology | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To prospectively evaluate if the perfusion parameters of gastric cancer can provide information on histologic subtypes of gastric cancer.

Methods

We performed preoperative perfusion CT (PCT) and curative gastrectomy in 46 patients. PCT data were analysed using a dedicated software program. Perfusion parameters were obtained by two independent radiologists and were compared according to histologic type using Kruskal–Wallis, Mann–Whitney U test and receiver operating characteristic analysis. To assess inter-reader agreement, we used intraclass correlation coefficient (ICC).

Results

Inter-reader agreement for perfusion parameters was moderate to substantial (ICC = 0.585–0.678). Permeability surface value of poorly cohesive carcinoma (PCC) was significantly higher than other histologic types (47.3 ml/100 g/min in PCC vs 26.5 ml/100 g/min in non-PCC, P < 0.001). Mean transit time (MTT) of PCC was also significantly longer than non-PCC (13.0 s in PCC vs 10.3 s in non-PCC, P = 0.032). The area under the curve to predict PCC was 0.891 (P < 0.001) for permeability surface and 0.697 (P = 0.015) for MTT.

Conclusion

Obtaining perfusion parameters from PCT was feasible in gastric cancer patients and can aid in the preoperative imaging diagnosis of PCC-type gastric cancer as the permeability surface and MTT value of PCC type gastric cancer were significantly higher than those of non-PCC.

Key points

Obtaining perfusion parameters from PCT was feasible in patients with gastric cancer.
Permeability surface and MTT were significantly higher in poorly cohesive carcinoma (PCC).
Permeability surface, MTT can aid in the preoperative imaging diagnosis of PCC.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108CrossRefPubMed Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108CrossRefPubMed
2.
Zurück zum Zitat Yao J, Yang ZG, Chen HJ, Chen TW, Huang J (2011) Gastric adenocarcinoma: can perfusion CT help to noninvasively evaluate tumor angiogenesis? Abdom Imaging 36:15–21CrossRefPubMed Yao J, Yang ZG, Chen HJ, Chen TW, Huang J (2011) Gastric adenocarcinoma: can perfusion CT help to noninvasively evaluate tumor angiogenesis? Abdom Imaging 36:15–21CrossRefPubMed
3.
Zurück zum Zitat Hu B, El Hajj N, Sittler S, Lammert N, Barnes R, Meloni-Ehrig A (2012) Gastric cancer: classification, histology and application of molecular pathology. J Gastrointest Oncol 3:251–261PubMedPubMedCentral Hu B, El Hajj N, Sittler S, Lammert N, Barnes R, Meloni-Ehrig A (2012) Gastric cancer: classification, histology and application of molecular pathology. J Gastrointest Oncol 3:251–261PubMedPubMedCentral
4.
Zurück zum Zitat Li ZS, Li Q (2011) The latest 2010 WHO classification of tumors of digestive system. Zhonghua Bing Li Xue Za Zhi 40:351–354PubMed Li ZS, Li Q (2011) The latest 2010 WHO classification of tumors of digestive system. Zhonghua Bing Li Xue Za Zhi 40:351–354PubMed
5.
Zurück zum Zitat Ribeiro MM, Sarmento JA, Sobrinho Simoes MA, Bastos J (1981) Prognostic significance of Lauren and Ming classifications and other pathologic parameters in gastric carcinoma. Cancer 47:780–784CrossRefPubMed Ribeiro MM, Sarmento JA, Sobrinho Simoes MA, Bastos J (1981) Prognostic significance of Lauren and Ming classifications and other pathologic parameters in gastric carcinoma. Cancer 47:780–784CrossRefPubMed
6.
Zurück zum Zitat Hass HG, Smith U, Jager C et al (2011) Signet ring cell carcinoma of the stomach is significantly associated with poor prognosis and diffuse gastric cancer (Lauren's): single-center experience of 160 cases. Onkologie 34:682–686CrossRefPubMed Hass HG, Smith U, Jager C et al (2011) Signet ring cell carcinoma of the stomach is significantly associated with poor prognosis and diffuse gastric cancer (Lauren's): single-center experience of 160 cases. Onkologie 34:682–686CrossRefPubMed
7.
Zurück zum Zitat Su JS, Chen YT, Wang RC, Wu CY, Lee SW, Lee TY (2013) Clinicopathological characteristics in the differential diagnosis of hepatoid adenocarcinoma: a literature review. World J Gastroenterol 19:321–327CrossRefPubMedPubMedCentral Su JS, Chen YT, Wang RC, Wu CY, Lee SW, Lee TY (2013) Clinicopathological characteristics in the differential diagnosis of hepatoid adenocarcinoma: a literature review. World J Gastroenterol 19:321–327CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Berlth F, Bollschweiler E, Drebber U, Hoelscher AH, Moenig S (2014) Pathohistological classification systems in gastric cancer: diagnostic relevance and prognostic value. World J Gastroenterol 20:5679–5684CrossRefPubMedPubMedCentral Berlth F, Bollschweiler E, Drebber U, Hoelscher AH, Moenig S (2014) Pathohistological classification systems in gastric cancer: diagnostic relevance and prognostic value. World J Gastroenterol 20:5679–5684CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Kwon KJ, Shim KN, Song EM et al (2014) Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the stomach. Gastric Cancer 17:43–53CrossRefPubMed Kwon KJ, Shim KN, Song EM et al (2014) Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the stomach. Gastric Cancer 17:43–53CrossRefPubMed
10.
Zurück zum Zitat Kim JP, Kim SC, Yang HK (1994) Prognostic significance of signet ring cell carcinoma of the stomach. Surg Oncol 3:221–227CrossRefPubMed Kim JP, Kim SC, Yang HK (1994) Prognostic significance of signet ring cell carcinoma of the stomach. Surg Oncol 3:221–227CrossRefPubMed
11.
Zurück zum Zitat Piessen G, Messager M, Leteurtre E, Jean-Pierre T, Mariette C (2009) Signet ring cell histology is an independent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation. Ann Surg 250:878–887CrossRefPubMed Piessen G, Messager M, Leteurtre E, Jean-Pierre T, Mariette C (2009) Signet ring cell histology is an independent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation. Ann Surg 250:878–887CrossRefPubMed
12.
Zurück zum Zitat Henson DE, Dittus C, Younes M, Nguyen H, Albores-Saavedra J (2004) Differential trends in the intestinal and diffuse types of gastric carcinoma in the United States, 1973-2000: increase in the signet ring cell type. Arch Pathol Lab Med 128:765–770PubMed Henson DE, Dittus C, Younes M, Nguyen H, Albores-Saavedra J (2004) Differential trends in the intestinal and diffuse types of gastric carcinoma in the United States, 1973-2000: increase in the signet ring cell type. Arch Pathol Lab Med 128:765–770PubMed
13.
Zurück zum Zitat Cunningham SC, Kamangar F, Kim MP et al (2005) Survival after gastric adenocarcinoma resection: eighteen-year experience at a single institution. J Gastrointest Surg 9:718–725CrossRefPubMed Cunningham SC, Kamangar F, Kim MP et al (2005) Survival after gastric adenocarcinoma resection: eighteen-year experience at a single institution. J Gastrointest Surg 9:718–725CrossRefPubMed
14.
Zurück zum Zitat Novotny AR, Schuhmacher C, Busch R, Kattan MW, Brennan MF, Siewert JR (2006) Predicting individual survival after gastric cancer resection: validation of a U.S.-derived nomogram at a single high-volume center in Europe. Ann Surg 243:74–81CrossRefPubMedPubMedCentral Novotny AR, Schuhmacher C, Busch R, Kattan MW, Brennan MF, Siewert JR (2006) Predicting individual survival after gastric cancer resection: validation of a U.S.-derived nomogram at a single high-volume center in Europe. Ann Surg 243:74–81CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Miles KA, Griffiths MR (2003) Perfusion CT: a worthwhile enhancement? Br J Radiol 76:220–231CrossRefPubMed Miles KA, Griffiths MR (2003) Perfusion CT: a worthwhile enhancement? Br J Radiol 76:220–231CrossRefPubMed
16.
Zurück zum Zitat Yi CA, Lee KS, Kim EA et al (2004) Solitary pulmonary nodules: dynamic enhanced multi-detector row CT study and comparison with vascular endothelial growth factor and microvessel density. Radiology 233:191–199CrossRefPubMed Yi CA, Lee KS, Kim EA et al (2004) Solitary pulmonary nodules: dynamic enhanced multi-detector row CT study and comparison with vascular endothelial growth factor and microvessel density. Radiology 233:191–199CrossRefPubMed
17.
Zurück zum Zitat Meijerink MR, van Waesberghe JH, van der Weide L, van den Tol P, Meijer S, van Kuijk C (2008) Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases. Eur Radiol 18:2345–2354CrossRefPubMed Meijerink MR, van Waesberghe JH, van der Weide L, van den Tol P, Meijer S, van Kuijk C (2008) Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases. Eur Radiol 18:2345–2354CrossRefPubMed
18.
Zurück zum Zitat Chen TW, Yang ZG, Li Y, Li ZL, Yao J, Sun JY (2009) Quantitative assessment of first-pass perfusion of oesophageal squamous cell carcinoma using 64-section MDCT: initial observation. Clin Radiol 64:38–45CrossRefPubMed Chen TW, Yang ZG, Li Y, Li ZL, Yao J, Sun JY (2009) Quantitative assessment of first-pass perfusion of oesophageal squamous cell carcinoma using 64-section MDCT: initial observation. Clin Radiol 64:38–45CrossRefPubMed
19.
Zurück zum Zitat Zhang H, Pan Z, Du L et al (2008) Advanced gastric cancer and perfusion imaging using a multidetector row computed tomography: correlation with prognostic determinants. Korean J Radiol 9:119–127CrossRefPubMedPubMedCentral Zhang H, Pan Z, Du L et al (2008) Advanced gastric cancer and perfusion imaging using a multidetector row computed tomography: correlation with prognostic determinants. Korean J Radiol 9:119–127CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Satoh A, Shuto K, Okazumi S et al (2010) Role of perfusion CT in assessing tumor blood flow and malignancy level of gastric cancer. Dig Surg 27:253–260CrossRefPubMed Satoh A, Shuto K, Okazumi S et al (2010) Role of perfusion CT in assessing tumor blood flow and malignancy level of gastric cancer. Dig Surg 27:253–260CrossRefPubMed
21.
Zurück zum Zitat Yao J, Yang ZG, Chen TW, Li Y, Yang L (2010) Perfusion changes in gastric adenocarcinoma: evaluation with 64-section MDCT. Abdom Imaging 35:195–202CrossRefPubMed Yao J, Yang ZG, Chen TW, Li Y, Yang L (2010) Perfusion changes in gastric adenocarcinoma: evaluation with 64-section MDCT. Abdom Imaging 35:195–202CrossRefPubMed
22.
Zurück zum Zitat Lee DH, Kim SH, Im SA, Oh DY, Kim TY, Han JK (2016) Multiparametric fully-integrated 18-FDG PET/MRI of advanced gastric cancer for prediction of chemotherapy response: a preliminary study. Eur Radiol 26:2771–2778CrossRefPubMed Lee DH, Kim SH, Im SA, Oh DY, Kim TY, Han JK (2016) Multiparametric fully-integrated 18-FDG PET/MRI of advanced gastric cancer for prediction of chemotherapy response: a preliminary study. Eur Radiol 26:2771–2778CrossRefPubMed
23.
Zurück zum Zitat Bang YJ, Van Cutsem E, Feyereislova A et al (2010) Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 376:687–697CrossRefPubMed Bang YJ, Van Cutsem E, Feyereislova A et al (2010) Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 376:687–697CrossRefPubMed
24.
Zurück zum Zitat Brix G, Bahner ML, Hoffmann U, Horvath A, Schreiber W (1999) Regional blood flow, capillary permeability, and compartmental volumes: measurement with dynamic CT--initial experience. Radiology 210:269–276CrossRefPubMed Brix G, Bahner ML, Hoffmann U, Horvath A, Schreiber W (1999) Regional blood flow, capillary permeability, and compartmental volumes: measurement with dynamic CT--initial experience. Radiology 210:269–276CrossRefPubMed
25.
Zurück zum Zitat Raghunand N, Gatenby RA, Gillies RJ et al (2003) Microenvironmental and cellular consequences of altered blood flow in tumours. Br J Radiol 76(Spec No 1):S11–S22CrossRefPubMed Raghunand N, Gatenby RA, Gillies RJ et al (2003) Microenvironmental and cellular consequences of altered blood flow in tumours. Br J Radiol 76(Spec No 1):S11–S22CrossRefPubMed
26.
Zurück zum Zitat Fukui Y (2014) Mechanisms behind signet ring cell carcinoma formation. Biochem Biophys Res Commun 450:1231–1233CrossRefPubMed Fukui Y (2014) Mechanisms behind signet ring cell carcinoma formation. Biochem Biophys Res Commun 450:1231–1233CrossRefPubMed
27.
Zurück zum Zitat Kim DY, Park YK, Joo JK et al (2004) Clinicopathological characteristics of signet ring cell carcinoma of the stomach. ANZ J Surg 74:1060–1064CrossRefPubMed Kim DY, Park YK, Joo JK et al (2004) Clinicopathological characteristics of signet ring cell carcinoma of the stomach. ANZ J Surg 74:1060–1064CrossRefPubMed
28.
Zurück zum Zitat Kim SH, Kim MA, Shin CI, Han JK, Choi BI (2015) CT differentiation of poorly-differentiated gastric neuroendocrine tumours from well-differentiated neuroendocrine tumours and gastric adenocarcinomas. Eur Radiol 25:1946–1957CrossRefPubMed Kim SH, Kim MA, Shin CI, Han JK, Choi BI (2015) CT differentiation of poorly-differentiated gastric neuroendocrine tumours from well-differentiated neuroendocrine tumours and gastric adenocarcinomas. Eur Radiol 25:1946–1957CrossRefPubMed
29.
Zurück zum Zitat Goh V, Halligan S, Bartram CI (2007) Quantitative tumor perfusion assessment with multidetector CT: are measurements from two commercial software packages interchangeable? Radiology 242:777–782CrossRefPubMed Goh V, Halligan S, Bartram CI (2007) Quantitative tumor perfusion assessment with multidetector CT: are measurements from two commercial software packages interchangeable? Radiology 242:777–782CrossRefPubMed
30.
Zurück zum Zitat Kudo K, Sasaki M, Yamada K et al (2010) Differences in CT perfusion maps generated by different commercial software: quantitative analysis by using identical source data of acute stroke patients. Radiology 254:200–209CrossRefPubMed Kudo K, Sasaki M, Yamada K et al (2010) Differences in CT perfusion maps generated by different commercial software: quantitative analysis by using identical source data of acute stroke patients. Radiology 254:200–209CrossRefPubMed
Metadaten
Titel
CT Perfusion evaluation of gastric cancer: correlation with histologic type
verfasst von
Dong Ho Lee
Se Hyung Kim
Ijin Joo
Joon Koo Han
Publikationsdatum
04.08.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 2/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4979-5

Weitere Artikel der Ausgabe 2/2018

European Radiology 2/2018 Zur Ausgabe

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.