Daisuke Tsurumaru1, Mitsutoshi Miyasaka2, Yusuke Nishimuta2, Yoshiki Asayama2, Akihiro Nishie2, Satoshi Kawanami3, Eiji Oki4, Minako Hirahashi5, Hiroshi Honda2. 1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan. tsuru-d@radiol.med.kyushu-u.ac.jp. 2. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan. 3. Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan. 4. Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan. 5. Department of Anatomic Pathology and Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
Abstract
OBJECTIVES: Early gastric cancer with ulceration (EGC-U) mimics advanced gastric cancer (AGC), as EGC-Us and ACGs often have similar endoscopic appearance to ulceration. The purpose of this retrospective study was to determine whether multiphasic dynamic multidetector CT (MDCT) can help differentiate EGC-Us from AGCs. METHODS: Patients with EGC-Us with ulcer stages Ul-III or IV and AGCs with tumour stages T2 to T4a were enrolled. MDCT images were obtained 40 s (arterial phase), 70 s (portal phase) and 240 s (delayed phase) after injection of non-ionic contrast material. Two readers independently measured the attenuation values of the lesions by placing regions of interest. We compared the EGC-Us and AGCs using the mean attenuation values in each phase and peak enhancement phase. We analysed the diagnostic performance of CT for differentiating EGC-Us from AGCs. RESULTS: Forty cases (16 EGC-Us and 24 AGCs) were analysed. The mean attenuation values of the EGC-Us were significantly lower than those of the AGCs in both the arterial and portal phases (all p < 0.0001 for each reader). The peak enhancement was significantly different between the EGC-Us and AGCs for both readers (Reader 1, p = 0.0131; Reader 2, p = 0.0006). CONCLUSION: Multiphasic dynamic contrast-enhanced MDCT can help differentiate EGC-Us from AGCs. KEY POINTS: • Early gastric cancer with ulceration and advanced gastric cancer have similar endoscopic appearances. • EGC-U shows significantly lower attenuation values in both arterial and portal phases. • Multiphasic dynamic contrast-enhanced MDCT differentiates EGC-U from AGC.
OBJECTIVES: Early gastric cancer with ulceration (EGC-U) mimics advanced gastric cancer (AGC), as EGC-Us and ACGs often have similar endoscopic appearance to ulceration. The purpose of this retrospective study was to determine whether multiphasic dynamic multidetector CT (MDCT) can help differentiate EGC-Us from AGCs. METHODS:Patients with EGC-Us with ulcer stages Ul-III or IV and AGCs with tumour stages T2 to T4a were enrolled. MDCT images were obtained 40 s (arterial phase), 70 s (portal phase) and 240 s (delayed phase) after injection of non-ionic contrast material. Two readers independently measured the attenuation values of the lesions by placing regions of interest. We compared the EGC-Us and AGCs using the mean attenuation values in each phase and peak enhancement phase. We analysed the diagnostic performance of CT for differentiating EGC-Us from AGCs. RESULTS: Forty cases (16 EGC-Us and 24 AGCs) were analysed. The mean attenuation values of the EGC-Us were significantly lower than those of the AGCs in both the arterial and portal phases (all p < 0.0001 for each reader). The peak enhancement was significantly different between the EGC-Us and AGCs for both readers (Reader 1, p = 0.0131; Reader 2, p = 0.0006). CONCLUSION: Multiphasic dynamic contrast-enhanced MDCT can help differentiate EGC-Us from AGCs. KEY POINTS: • Early gastric cancer with ulceration and advanced gastric cancer have similar endoscopic appearances. • EGC-U shows significantly lower attenuation values in both arterial and portal phases. • Multiphasic dynamic contrast-enhanced MDCT differentiates EGC-U from AGC.
Authors: Y Niwa; S Nakazawa; Y Tsukamoto; H Goto; S Hase; S Ohashi; K Mizutani; H Yoshikane; J Yoshino; T Nakamura Journal: Scand J Gastroenterol Date: 1991-05 Impact factor: 2.423
Authors: Sung Wook Hwang; Dong Ho Lee; Sang Hyub Lee; Young Soo Park; Jin Hyeok Hwang; Jin Wook Kim; Sook Hyang Jung; Na Young Kim; Young Hoon Kim; Kyoung Ho Lee; Hyung-Ho Kim; Do Joong Park; Hye Seung Lee; Hyun Chae Jung; In Sung Song Journal: J Gastroenterol Hepatol Date: 2010-03 Impact factor: 4.029
Authors: Francesco Giganti; Sofia Antunes; Annalaura Salerno; Alessandro Ambrosi; Paolo Marra; Roberto Nicoletti; Elena Orsenigo; Damiano Chiari; Luca Albarello; Carlo Staudacher; Antonio Esposito; Alessandro Del Maschio; Francesco De Cobelli Journal: Eur Radiol Date: 2016-08-23 Impact factor: 5.315