<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2017-0002_s_333_w2aab3b8ab1b7b1aab1c15b1Aa"><h3>Background</h3><p>Diagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared.</p></sec><sec id="j_raon-2017-0002_s_334_w2aab3b8ab1b7b1aab1c15b2Aa"><h3>Patients and methods</h3><p>We used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm2) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used.</p></sec><sec id="j_raon-2017-0002_s_335_w2aab3b8ab1b7b1aab1c15b3Aa"><h3>Results</h3><p>Sensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%.</p></sec><sec id="j_raon-2017-0002_s_336_w2aab3b8ab1b7b1aab1c15b4Aa"><h3>Conclusions</h3><p>The diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy.</p></sec></abstract>

BackgroundDiagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared.Patients and methodsWe used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm2) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used.ResultsSensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%.ConclusionsThe diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy.

Contribution of diffusion weighted MRI to diagnosis and staging in gastric tumors and comparison with multi-detector computed tomography

Radiology and Oncology

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

BackgroundDiagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph...

Contribution of diffusion weighted MRI to diagnosis and staging in gastric tumors and comparison with multi-detector computed tomography

Article Category: Research Article

Published Online: Feb 22, 2017

Page range: 23 - 29

Received: Feb 07, 2016

Accepted: Aug 24, 2016

DOI: https://doi.org/10.1515/raon-2017-0002

Keywords
gastric cancer, diffusion weighted imaging, MDCT, staging

© 2017 Harun Arslan, Mehmet Fatih Özbay, İskan Çallı, Erkan Doğan, Sebahattin Çelik, Abdussamet Batur, Aydın Bora, Alpaslan Yavuz, Mehmet Deniz Bulut, Mesut Özgökçe, Mehmet Çetin Kotan

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Contribution of diffusion weighted MRI to diagnosis and staging in gastric tumors and comparison with multi-detector computed tomography

Article Category: Research Article

Published Online: Feb 22, 2017

Page range: 23 - 29

Received: Feb 07, 2016

Accepted: Aug 24, 2016

DOI: https://doi.org/10.1515/raon-2017-0002

Keywordsgastric cancer, diffusion weighted imaging, MDCT, staging

© 2017 Harun Arslan, Mehmet Fatih Özbay, İskan Çallı, Erkan Doğan, Sebahattin Çelik, Abdussamet Batur, Aydın Bora, Alpaslan Yavuz, Mehmet Deniz Bulut, Mesut Özgökçe, Mehmet Çetin Kotan

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords
gastric cancer, diffusion weighted imaging, MDCT, staging