Value Of Contrast-Enhanced MDCT With Special Multiplanar Reformation In Preoperative Local Staging Of Gastric Cancer

Objective: To evaluate the reliability of special reconstruction methodcombined with cross section image in assessing T staging of gastric cancer andto analyze accuracy of different imaging features in diagnosing serosal invasion with MDCT.Methods: 212 patients with biopsy-proven gastric cancer were examined preoperatively by MDCT.All MDCT examinations were performed using a 16 detector-row CT scanner(Philips)before surgery.MPR(including special coronal / sagittal and routine coronal / sagittal)were reconstructed on the workstation by an experienced technician.And then,two experienced abdomen radiologists who were blinded to the biopsy findings evaluated the MDCTreformatted images produced with MPR combined with cross section image for Tstaging,recorded the tumor site and serosal invasion imaging features.The MDCT staging of the patients was compared with the histopathological results.All statistical analysis were performed using SPSS21.0 software.Result:(1)The accuracy of Tstaging of gastric cancer with sMPR combined with cross section image(83.0%)was significantlyhigherthan withr MPR combined with cross section image(64.2%),P<0.05.In terms of local tumor stage,the sMPR combined with axial image was good consistent with the postoperativepathology(Kappa value=0.785),while the rMPR combined with axial image was onlymoderate consistent(Kappavalue=0.546).(2)The accuracy of Tstaging of gastric cancer with sMRP combined with axial image and cMPR combined with axial image for T3,T4 a and T4 b in site of gastroesophageal junction andgastric angle were96.7% vs 80.0%?98.3% vs 80.0%?98.3% vs 90.0%,respectively,P<0.05.(3)The accuracy ofthe serosal invasion with imaging feature of texture of serosal surface(rough or nodular)and of surrounding fat(blurr or absence of fat)was 81.1%,71.7%,respectively.(P<0.05).Conclusion:The sMPR combined with axial image is superior to the rMPR combined with axial image for T staging of gastric cancer with MDCT,specially in staging of tumor located at gastro-esophageal juction,gastric angle for T3 and T4 stage.The accuracy of predicting the serosal invasion with imaging feature of texture of serosal surface was higher thanwith imaging feature of surrounding fat.