| Helical CT evaluation of the preoperative staging of gastric cancer in the remnant stomach. | |
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MedLine Citation:
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PMID: 19304693 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of our study was to evaluate the diagnostic performance of helical CT for evaluating the preoperative staging of gastric cancer in the remnant stomach. MATERIALS AND METHODS: Preoperative helical CT images of 67 patients with gastric cancer in the remnant stomach were independently analyzed regarding staging of the tumor by two radiologists who were blinded to histopathologic and surgical results. The differences in their assessments were resolved by consensus including the opinion of a third radiologist. The radiologists were asked to determine the depth of tumor invasion of the gastric wall (T stage), classifying it as </= T2, T3, or T4; local lymph node involvement (N stage); and solid organ metastasis or peritoneal involvement (M stage). TNM staging on CT was correlated with the histopathologic results of the resected specimen or with the surgical findings. Interobserver agreement was assessed using weighted kappa statistics. RESULTS: The overall accuracy of T staging for reviewers 1 and 2 and for the consensus reading were 83.6%, 78.2%, and 85.4%, respectively. Five of 34 </= T2 lesions were misdiagnosed as T3. The cause of the overstaging was the misconception of the postoperative fibrotic change of the anastomotic site as perigastric tumoral infiltration. Three of 18 T4 lesions were understaged because of inadequate gastric distention (n = 1) and misinterpretation of adjacent organ involvement as partial volume averaging (n = 2). The accuracy of N staging and M staging were 81.8% and 94.0% for reviewer 1; 78.2% and 91.0% for reviewer 2; and 81.8% and 94.0% for the consensus reading, respectively. The weighted kappa values of T staging, N staging, and M staging were 0.676, 0.619, and 0.924, respectively. CONCLUSION: Contrast-enhanced helical CT can be used successfully to preoperatively evaluate the staging of remnant stomach cancer in patients who have undergone previous gastric resection. |
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Authors:
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In Joon Lee; Jeong Min Lee; Se Hyung Kim; Samuel Chang; Joon Koo Han; Byung Ihn Choi; Hyuk-Joon Lee; Han-Kwang Yang; Kuhn Uk Lee |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 192 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-23 Completed Date: 2009-04-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 902-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology, Seoul National University Hospital, 28 Yeongon-dong, Jongno-gu, Seoul 110-744, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
/
pathology,
radiography*,
surgery Adult Aged Aged, 80 and over Contrast Media Female Gastrectomy Gastric Stump / pathology, radiography*, surgery Humans Iohexol / analogs & derivatives, diagnostic use Male Middle Aged Neoplasm Staging Preoperative Care Radiographic Image Interpretation, Computer-Assisted Retrospective Studies Stomach Neoplasms / pathology, radiography*, surgery Tomography, Spiral Computed / methods* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 66108-95-0/Iohexol; 73334-07-3/iopromide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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