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01.12.2012 | Research | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Preoperative multidetector-row computed tomography scan staging for lymphatic gastric cancer spread

World Journal of Surgical Oncology > Ausgabe 1/2012
Paolo Morgagni, Enrico Petrella, Barbara Basile, Alberto Mami, Augusto Soro, Andrea Gardini, Filippo Calzolari, Domenico Garcea, Mauro Bertocco
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-197) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

PM, BB, EP, and DG were involved in study conception and design; EP, AM, FC, BB, PM, and AS carried out data acquisition; EP, AM, FC, BB, PM, and AG were responsible for quality control of data and algorithms; AG and PM carried out data analysis and interpretation; PM, DG and FC drafted the manuscript. All authors read and approved the final manuscript.



Multidetector-row computed tomography (MDCT) is commonly used to stage patients with gastric cancer, even though the technique often shows low specificity for lymph-node involvement.


In this study, 111 patients with gastric cancer who consecutively underwent MDCT scan followed by radical surgical treatment at our hospital were retrospectively evaluated.


In total, 3632 lymph nodes from 643 lymphatic stations were studied and then correlated with radiological features. Lymph-node size was not always associated with infiltration. Of the 261 lymph-node stations that were not radiologically detected, 60 (22.9%) were infiltrated. There were 108 stations with lymph nodes larger than 10 mm seen on MDCT, of which 67 (62%) had lymphatic invasion. The sensitivity was 32.6%, specificity 90.6%, positive predictive value 62.0%, negative predictive value 74.2%, and accuracy 72.1%. When three lymph nodes, at least one of which was larger than 10 mm, were detected in the same station, infiltration was confirmed with 99% specificity in 93.8% of patients. Moreover, all of the 13 patients in whom three lymph nodes larger than 10 mm were detected in different neighboring stations had lymphatic invasion.


Although presence of lymph nodes greater than 10 mm in size is not, in itself, sufficient to confirm lymphatic invasion, nodal involvement can be hypothesized when associated images are detected by MDCT.
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