Skip to main content

Advertisement

SpringerLink
Log in

Impact of the Cross-Sectional Location of Multidetector Computed Tomography Scans on Prediction of Serosal Exposure in Patients with Advanced Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The extent of serosal exposure varies depending on the cross-section of the stomach that is viewed, affected by the visceral peritoneum of the omentum. Although multidetector computed tomography (MDCT) is the most useful method to predict serosal exposure, the MDCT criteria for such exposure by cross-sectional location remain to be established.

Methods

The MDCT of gastric cancer patients who underwent surgery, and for whom pathological reports were available, were reviewed by radiologists. The MDCT criteria for invasion depth were divided into five grades: (1) smooth margin; (2) undulating margin; (3) streaky margin within vessels; (4) nodular margin within perigastric vessels; and (5) streaky or nodular margin over the perigastric vessels. The five grades were compared in terms of pathological tumor depth by curvature and wall group.

Results

A total of 125 patients of stage ≥ T2 were enrolled. The five MDCT grades correlated with tumor depth (P < 0.001). Exposed serosal lesions of grade 3 (P = 0.031) and 5 (P = 0.030) constituted significantly the largest proportion of wall and curvature cancers, respectively. The accuracy of MDCT in terms of T staging using the five grades was calculated by cross-sectional location. The highest accuracies were associated with curvature- and wall-located tumors (55.1 and 64.3%, respectively) when serosal exposure was graded 5 and 3, respectively. The highest overall accuracy for T staging was 59.2% when the various MDCT criteria were applied by reference to the cross-sectional location.

Conclusions

The MDCT criteria for serosal exposure vary by the cross-sectional location of the gastric cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kim JM, Jung H, Lee JS, et al. Clinical implication of serosal change in pathologic subserosa-limited gastric cancer. World J Surg. 2012;36:355-61.

    Article  PubMed  Google Scholar 

  2. Kim DJ, Lee JH, Kim W. Impact of intraoperative macroscopic diagnosis of serosal invasion in pathological subserosal (pT3) gastric cancer. J Gastric Cancer. 2014;14:252-8.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hur H, Lee HH, Jung H, Song KY, Jeon HM, Park CH. Predicting factors of unexpected peritoneal seeding in locally advanced gastric cancer: indications for staging laparoscopy. J Surg Oncol. 2010;102:753-7.

    Article  PubMed  Google Scholar 

  4. Bentrem D, Gerdes H, Tang L, Brennan M, Coit D. Clinical correlation of endoscopic ultrasonography with pathologic stage and outcome in patients undergoing curative resection for gastric cancer. Ann Surg Oncol. 2007;14:1853-9.

    Article  PubMed  Google Scholar 

  5. Smith JW, Brennan MF, Botet JF, Gerdes H, Lightdale CJ. Preoperative endoscopic ultrasound can predict the risk of recurrence after operation for gastric carcinoma. J Clin Oncol. 1993;11:2380-5.

    Article  CAS  PubMed  Google Scholar 

  6. Lee HH, Lim CH, Park JM, et al. Low accuracy of endoscopic ultrasonography for detailed T staging in gastric cancer. World J Surg Oncol. 2012;10:190.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Reddy NK, Markowitz AB, Abbruzzese JL, Bhutani MS. Knowledge of indications and utilization of EUS: a survey of oncologists in the United States. J Clin Gastroenterol. 2008;42:892-6.

    Article  PubMed  Google Scholar 

  8. Lee SL, Lee HH, Ku YM, Jeon HM. Usefulness of two-dimensional values measured using preoperative multidetector computed tomography in predicting lymph node metastasis of gastric cancer. Ann Surg Oncol. 2015;22 Suppl 3:S786-93.

    Article  PubMed  Google Scholar 

  9. Lee MH, Choi D, Park MJ, Lee MW. Gastric cancer: imaging and staging with MDCT based on the 7th AJCC guidelines. Abdom Imaging. 2012;37:531-40.

    Article  PubMed  Google Scholar 

  10. Chen CY, Hsu JS, Wu DC, et al. Gastric cancer: preoperative local staging with 3D multi-detector row CT—correlation with surgical and histopathologic results. Radiology. 2007;242:472-82.

    Article  PubMed  Google Scholar 

  11. Kim HJ, Kim AY, Oh ST, et al. Gastric cancer staging at multi-detector row CT gastrography: comparison of transverse and volumetric CT scanning. Radiology. 2005;236:879-85.

    Article  PubMed  Google Scholar 

  12. Kim TU, Kim S, Lee JW, Lee NK, Jeon TY, Park DY. MDCT features in the differentiation of T4a gastric cancer from less-advanced gastric cancer: significance of the hyperattenuating serosa sign. Br J Radiol. 2013;86:20130290.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. American Joint Committee on Cancer (AJCC) cancer staging manual, 7th ed. New York: Springer; 2010.

    Google Scholar 

  14. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101-12.

    Article  Google Scholar 

  15. Kim JW, Shin SS, Heo SH, et al. Diagnostic performance of 64-section CT using CT gastrography in preoperative T staging of gastric cancer according to 7th edition of AJCC cancer staging manual. Eur Radiol. 2012;22:654-62.

    Article  PubMed  Google Scholar 

  16. Yan C, Zhu ZG, Yan M, et al. Value of multidetector-row computed tomography in the preoperative T and N staging of gastric carcinoma: a large-scale Chinese study. J Surg Oncol. 2009;100:205-14.

    Article  PubMed  Google Scholar 

  17. Shimizu K, Ito K, Matsunaga N, Shimizu A, Kawakami Y. Diagnosis of gastric cancer with MDCT using the water-filling method and multiplanar reconstruction: CT-histologic correlation. AJR Am J Roentgenol. 2005;185:1152-8.

    Article  PubMed  Google Scholar 

  18. Kumano S, Murakami T, Kim T, et al. T staging of gastric cancer: role of multi-detector row CT. Radiology. 2005;237:961-6.

    Article  PubMed  Google Scholar 

  19. Furukawa K, Miyahara R, Itoh A, et al. Diagnosis of the invasion depth of gastric cancer using MDCT with virtual gastroscopy: comparison with staging with endoscopic ultrasound. AJR Am J Roentgenol. 2011;197:867-75.

    Article  PubMed  Google Scholar 

  20. Hasegawa S, Yoshikawa T, Shirai J, et al. A prospective validation study to diagnose serosal invasion and nodal metastases of gastric cancer by multidetector-row CT. Ann Surg Oncol. 2013;20:2016-22.

    Article  PubMed  Google Scholar 

  21. Kumano S, Okada M, Shimono T, et al. T-staging of gastric cancer of air-filling multidetector-row CT: comparison with hydro-multidetector-row CT. Eur J Radiol. 2012;81:2953-60.

    Article  PubMed  Google Scholar 

  22. Kim AY, Kim HJ, Ha HK. Gastric cancer by multidetector row CT: preoperative staging. Abdom Imaging. 2005;30:465-72.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgement

This study was supported by Grants from the National Research Foundation of Korea (Nos. 2012R1A1A1043576 and 2015R1A1A1A05028000) and the Catholic Medical Center Research Foundation (in program year 2015).

Disclosures

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Su Lim Lee MD & Young Mi Ku MD

  2. Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Hae Myung Jeon MD & Han Hong Lee MD

  3. Department of Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyenggi-Do, Korea

    Han Hong Lee MD

Authors
  1. Su Lim Lee MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Young Mi Ku MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hae Myung Jeon MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Han Hong Lee MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Han Hong Lee MD.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 17 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, S.L., Ku, Y.M., Jeon, H.M. et al. Impact of the Cross-Sectional Location of Multidetector Computed Tomography Scans on Prediction of Serosal Exposure in Patients with Advanced Gastric Cancer. Ann Surg Oncol 24, 1003–1009 (2017). https://doi.org/10.1245/s10434-016-5670-9

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-016-5670-9

Keywords

Search

Navigation