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CT volumetry for gastric carcinoma: association with TNM stage

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

We evaluated the feasibility of performing CT volumetry of gastric carcinoma (GC) and its correlation with TNM stage.

Methods

This institutional review board-approved retrospective study was performed on 153 patients who underwent a staging CT study for histologically confirmed GC. CT volumetry was performed by drawing regions of interest including abnormal thickening of the stomach wall. Reproducibility of tumour volume (Tvol) between two readers was assessed. Correlation between Tvol and TNM/peritoneal staging derived from histology/surgical findings was evaluated using ROC analysis and compared with CT evaluation of TNM/peritoneal staging.

Results

Tvol was successfully performed in all patients. Reproducibility among readers was excellent (r = 0.97; P = 0.0001). The median Tvol of GC showed an incremental trend with T-stage (T1 = 27 ml; T2 = 32 ml; T3 = 53 ml and T4 = 121 ml, P < 0.01). Tvol predicted with good accuracy T-stage (≥T2:0.95; ≥T3:0.89 and T4:0.83, P = 0.0001), M-stage (0.87, P = 0.0001), peritoneal metastases (0.87, P = 0.0001) and final stage (≥stage 2:0.89; ≥stage 3:0.86 and stage 4:0.87, P = 0.0001), with moderate accuracy for N-stage (≥N1:0.75; ≥N2:0.74 and N3:0.75, P = 0.0001). Tvol was significantly (P < 0.05) more accurate than standard CT staging for prediction of T-stage, N3-stage, M-stage and peritoneal metastases.

Conclusion

CT volumetry may provide useful adjunct information for preoperative staging of GC.

Key Points

• CT volumetry of gastric carcinoma is feasible and reproducible.

• Tumour volume <19.4 ml predicts T1-stage gastric cancer with 91 % sensitivity and 100 % specificity (P = 0.0001).

• Tumour volume >95.7 ml predicts metastatic gastric cancer with 87 % sensitivity and 78.5 % specificity (P = 0.0001).

• CT volumetry may be a useful adjunct for staging gastric carcinoma.

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Abbreviations

Tvol:

Tumour volumetry

GC:

Gastric cancer

AJCC:

American Joint Committee on Cancer

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Acknowledgments

The scientific guarantor of this publication is Dr Sudhakar K. Venkatesh. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this article. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. The study subjects or cohorts have not been previously reported. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Diagnostic Radiology, National University Health System (NUHS), Singapore, Singapore

    James T. P. D. Hallinan, Luke Peter & Andrew Makmur

  2. Department of Radiology, Mayo Clinic, 200, First Street SW, Rochester, MN, 55905, USA

    Sudhakar K. Venkatesh

  3. Hematology and Oncology, NUHS, Singapore, Singapore

    Wei Peng Yong

  4. Surgery, NUHS, Singapore, Singapore

    Jimmy B. Y. So

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  1. James T. P. D. Hallinan
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Correspondence to Sudhakar K. Venkatesh.

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Hallinan, J.T.P.D., Venkatesh, S.K., Peter, L. et al. CT volumetry for gastric carcinoma: association with TNM stage. Eur Radiol 24, 3105–3114 (2014). https://doi.org/10.1007/s00330-014-3316-5

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  • DOI: https://doi.org/10.1007/s00330-014-3316-5

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