Accuracy of MSCT and DCE-MRI in evaluating preoperative TNM staging of gastric cancer

doi:10.3877/cma.j.issn.2095-2015.2024.06.007

Abstract

Abstract:

Objective

To analyze the consistency between preoperative multi-slice spiral CT（MSCT） and dynamic contrast enhanced MRI （DCE-MRI） diagnosis of TNM staging and postoperative pathological results of gastric cancer，in order to provide reliable imaging data for clinical treatment.

Methods

A total of 102 patients with gastric cancer confirmed by gastroscopy biopsy and pathology in our hospital from January 2022 to December 2023 were selected，who underwent MSCT and DCE-MRI examinations and underwent concurrent surgical treatment. MSCT and MRI images were reviewed by two radiologists with more than 10 years of experience in double-blind method. Postoperative pathologic results were used as the gold standard to calculate the accuracy of different examinations in evaluating TNM staging of gastric cancer. Kappa test was used to analyze the consistency of MSCT and DCE-MRI examination results with postoperative pathological findings.

Results

The postoperative pathological results of 102 patients showed that there were 20，18，21 and 43 cases in T_1-4 stage，respectively，and 28，19，18 and 37 cases in N_0-3 stage，respectively. There were 98 cases of M₀ stage and 4 cases of M₁ stage.Compared with postoperative pathological findings，the total accuracy of MSCT examination in the diagnosis of gastric cancer T stage was 72.54% （74/102），which was significantly lower than that of DCE-MRI （91.17%，93/102）. The total accuracy of MSCT in the diagnosis of N stage of gastric cancer was 72.54% （74/102），which was significantly lower than 86.27% （88/102） of DCE-MRI. The overall accuracy of MSCT in the diagnosis of M stage of gastric cancer was 92.15% （94/102），which was not significantly different from that of DCE-MRI （97.05%，99/102）. The Kappa value of MSCT and DCE-MRI in the diagnosis of M stage of gastric cancer was similar （0.927 vs. 0.958）. The Kappa values of DCE-MRI in the diagnosis of T and N stage of gastric cancer were 0.927 and 0.876，respectively，which were better than those of MSCT.

Conclusion

Compared with MSCT examination，DCE-MRI has higher accuracy in evaluating TNM staging of gastric cancer and more significant consistent with postoperative pathology，which can provide powerful imaging support for preoperative diagnosis of gastric cancer.

Key words: Stomach neoplasms, Tomography,X-ray computer, Magnetic resonance imaging, TNM staging, Pathology, Consistency

Lijun Zhang, Cunjie Sun, Chunfeng Hu, Chong Meng, Hui Zhang. Accuracy of MSCT and DCE-MRI in evaluating preoperative TNM staging of gastric cancer[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(06): 519-523.

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URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2024.06.007

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References 20

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类别	例数	%
病灶位置
胃小弯	74	72.55
胃大弯	13	12.75
后壁	10	9.80
前壁	2	1.96
环形	3	2.94
病灶位置
上1/3	12	11.76
中1/3	29	28.43
下1/3	61	59.80
pT
T1a	1	0.98
T1b	19	18.63
T2	18	17.65
T3	21	20.59
T4a	19	18.63
T4b	24	23.53
pN
N0	28	27.45
N1	19	18.63
N2	18	17.65
N3a	23	22.55
N3b	14	13.73
pM
M0	98	96.08
M1	4	3.92

类别	例数	%
病灶位置
胃小弯	74	72.55
胃大弯	13	12.75
后壁	10	9.80
前壁	2	1.96
环形	3	2.94
病灶位置
上1/3	12	11.76
中1/3	29	28.43
下1/3	61	59.80
pT
T1a	1	0.98
T1b	19	18.63
T2	18	17.65
T3	21	20.59
T4a	19	18.63
T4b	24	23.53
pN
N0	28	27.45
N1	19	18.63
N2	18	17.65
N3a	23	22.55
N3b	14	13.73
pM
M0	98	96.08
M1	4	3.92

检查方法	术后病理检查（例）					准确率（%）
检查方法	T1	T2	T3	T4	合计	准确率（%）
MSCT
T1	14	2	4	0	20	70.00
T2	3	11	4	0	18	61.11
T3	4	5	9	3	21	42.85
T4	0	0	3	40	43	93.02
合计	21	18	20	43	102	72.54
DCE-MRI
T1	18	1	1	0	20	90.00
T2	2	15	1	0	18	83.33
T3	1	1	18	1	21	85.71
T4	0	0	1	42	43	97.67
合计	21	17	21	43	102	91.17^*

检查方法	术后病理检查（例）					准确率（%）
检查方法	T1	T2	T3	T4	合计	准确率（%）
MSCT
T1	14	2	4	0	20	70.00
T2	3	11	4	0	18	61.11
T3	4	5	9	3	21	42.85
T4	0	0	3	40	43	93.02
合计	21	18	20	43	102	72.54
DCE-MRI
T1	18	1	1	0	20	90.00
T2	2	15	1	0	18	83.33
T3	1	1	18	1	21	85.71
T4	0	0	1	42	43	97.67
合计	21	17	21	43	102	91.17^*

检查方法	术后病理检查（例）					准确率（%）
检查方法	N0	N1	N2	N3	合计	准确率（%）
MSCT
N0	25	2	1	0	28	89.28
N1	3	12	4	0	19	63.15
N2	1	5	6	6	18	33.33
N3	0	0	6	31	37	56.75
合计	29	19	17	37	102	72.54
DCE-MRI
N0	26	1	1	0	28	92.85
N1	2	15	2	0	19	78.94
N2	1	2	13	2	18	72.22
N3	0	0	3	34	37	91.89
合计	29	18	19	36	102	86.27^*

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