Comparison of Different Methods of Multislice Spiral Computed Tomography for the Preoperative Gastric Cancer Staging

Abstract

Background: To evaluate the diagnostic possibilities of multislice spiral computed tomography (MSCT) in preoperative gastric cancer staging. Methods: A total of 108 patients who had radical gastric cancer surgery were evaluated with MSCT two weeks before surgery in two different stomach imaging methods (water or urographin aqueous solution). Tumor staging was evaluated using the Tumor-Node-Metastasis (TNM) staging. The results from the imaging modalities were compared with the postoperative histopathological outcomes. Results: CT scanning with stomach contrast agent is more accurate (p < 0.05) and specific (p = 0.001) in determining stage T2; however hydrodynamic method is more sensitive (p < 0.005) and has higher PPV (p < 0.005). For stage T3, there was no significant difference between accuracy, positive and negative prognostic values; scanning with stomach contrast was more sensitive (p = 0.016), and hydrodynamic method was more specific (p = 0.026). For stage T4, hydrodynamic method was more sensitive (p = 0.028), but there was no significant difference between accuracy, specificity, positive and negative prognostic values. Conclusions: According to our study results, CT scanning with contrast agent is more accurate and specific in preoperative determination of gastric cancer T2 stage; however hydrodynamic method is more sensitive in preoperative T3 stage determination. We find no significant difference between positive and negative prognostic values of these methods. Scanning with contrast agent was more sensitive, and hydrodynamic method was more specific. Hydrodynamic method is more sensitive in determining gastric cancer T4 stage. CT scan is informative in preoperative gastric cancer M staging; however it is not informative enough for preoperative N staging.