The online version of this article (doi:10.1186/1477-7819-10-197) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
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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Sobin LH, Wittekind C: TNM classification of malignant tumors. 2009, New York, NY: Wiley
Hwang SW, Lee DH, Lee SH, Park YS, Hwang JH, Kim JW, Jung SH, Kim NY, Kim YH, Lee KH, Kim HH, do Park J, Lee HS, Jung HC, Song IS: Preoperative staging of gastric cancer by endoscopic ulotrasonography and multidetector-row computed tomography. J Gastroenterol Hepatol. 2010, 25: 512-518. 10.1111/j.1440-1746.2009.06106.x. CrossRefPubMed
Chen BB, Liang PC, Liu KL, Hsiao JK, Huang JC, Wong JM, Lee PH, Shun CT, Ming-Tsang Y: Preoperative diagnosis of gastric tumors by three dimensional multidetector row CT and double contrast barium meal study; correlation with surgical and histologic results. J Formos Med Assoc. 2007, 106: 943-952. 10.1016/S0929-6646(08)60065-0. CrossRefPubMed
Marrelli D, Mazzei MA, Pedrazzani C, Di Martino M, Vindigni C, Corso G, Morelli E, Volterrani L, Roviello F: High accuracy of multislice computed tomography (MSCT) for paraortic lymph node metastases for gastric cancer: a prospective single center study. Ann Surg Oncol. 2011, 18: 2265-2272. 10.1245/s10434-010-1541-y. CrossRefPubMed
- Preoperative multidetector-row computed tomography scan staging for lymphatic gastric cancer spread
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