Zelan Ma1,2, Changhong Liang2, Yanqi Huang2, Lan He2,3, Cuishan Liang1,2, Xin Chen4, Xiaomei Huang1,2, Yabing Xiong1, Zaiyi Liu5,6. 1. Southern Medical University, Guangzhou, Guangdong, 510515, China. 2. Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province, 510080, China. 3. School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China. 4. Department of Radiology, The Affiliated Guangzhou First People' Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510180, China. 5. Southern Medical University, Guangzhou, Guangdong, 510515, China. zyliu@163.com. 6. Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province, 510080, China. zyliu@163.com.
Abstract
OBJECTIVES: To determine whether multiphasic dynamic CT can preoperatively predict lymphovascular invasion (LVI) in advanced gastric cancer (AGC). METHODS: 278 patients with AGC who underwent preoperative multiphasic dynamic CT were retrospectively recruited. Tumour CT attenuation difference between non-contrast and arterial (ΔAP), portal (ΔPP) and delayed phase (ΔDP), tumour-spleen attenuation difference in the portal phase (ΔT-S), tumour contrast enhancement ratios (CERs), tumour-to-spleen ratio (TSR) and tumour volumes were obtained. All CT-derived parameters and clinicopathological variables associated with LVI were analysed by univariate analysis, followed by multivariate and receiver operator characteristics (ROC) analysis. Associations between CT predictors for LVI and histopathological characteristics were evaluated by the chi-square test. RESULTS: ΔPP (OR, 1.056; 95% CI: 1.032-1.080) and ΔT-S (OR, 1.043; 95% CI: 1.020-1.066) are independent predictors for LVI in AGC. ΔPP, ΔT-S and their combination correctly predicted LVI in 74.8% (AUC, 0.775; sensitivity, 88.6%; specificity, 54.1%), 68.7% (AUC, 0.747; sensitivity, 68.3%; specificity, 69.4%) and 71.7% (AUC, 0.800; sensitivity, 67.6%; specificity, 77.8%), respectively. There were significant associations between CT predictors for LVI with tumour histological differentiation and Lauren classification. CONCLUSION: Multiphasic dynamic CT provides a non-invasive method to predict LVI in AGC through quantitative enhancement measurement. KEY POINTS: • Lymphovascular invasion rarely can be evaluated preoperatively in advanced gastric cancer (AGC). • Δ PP and Δ T-S were independent predictors for LVI in patients with AGC. • Δ PP and Δ T-S showed acceptable predictive performance for LVI. • Combination of Δ PP and Δ T-S improved predictive performance for LVI. • Multiphasic dynamic CT may be a useful adjunct for detecting LVI preoperatively.
OBJECTIVES: To determine whether multiphasic dynamic CT can preoperatively predict lymphovascular invasion (LVI) in advanced gastric cancer (AGC). METHODS: 278 patients with AGC who underwent preoperative multiphasic dynamic CT were retrospectively recruited. Tumour CT attenuation difference between non-contrast and arterial (ΔAP), portal (ΔPP) and delayed phase (ΔDP), tumour-spleen attenuation difference in the portal phase (ΔT-S), tumour contrast enhancement ratios (CERs), tumour-to-spleen ratio (TSR) and tumour volumes were obtained. All CT-derived parameters and clinicopathological variables associated with LVI were analysed by univariate analysis, followed by multivariate and receiver operator characteristics (ROC) analysis. Associations between CT predictors for LVI and histopathological characteristics were evaluated by the chi-square test. RESULTS: ΔPP (OR, 1.056; 95% CI: 1.032-1.080) and ΔT-S (OR, 1.043; 95% CI: 1.020-1.066) are independent predictors for LVI in AGC. ΔPP, ΔT-S and their combination correctly predicted LVI in 74.8% (AUC, 0.775; sensitivity, 88.6%; specificity, 54.1%), 68.7% (AUC, 0.747; sensitivity, 68.3%; specificity, 69.4%) and 71.7% (AUC, 0.800; sensitivity, 67.6%; specificity, 77.8%), respectively. There were significant associations between CT predictors for LVI with tumour histological differentiation and Lauren classification. CONCLUSION: Multiphasic dynamic CT provides a non-invasive method to predict LVI in AGC through quantitative enhancement measurement. KEY POINTS: • Lymphovascular invasion rarely can be evaluated preoperatively in advanced gastric cancer (AGC). • Δ PP and Δ T-S were independent predictors for LVI in patients with AGC. • Δ PP and Δ T-S showed acceptable predictive performance for LVI. • Combination of Δ PP and Δ T-S improved predictive performance for LVI. • Multiphasic dynamic CT may be a useful adjunct for detecting LVI preoperatively.
Authors: Honsoul Kim; Mi-Suk Park; Jin Young Choi; Young Nyun Park; Myeong-Jin Kim; Kyung Sik Kim; Jin Sub Choi; Kwang-Hyub Han; EunJu Kim; Ki Whang Kim Journal: Eur Radiol Date: 2009-02-27 Impact factor: 5.315
Authors: Timothy P Padera; Ananth Kadambi; Emmanuelle di Tomaso; Carla Mouta Carreira; Edward B Brown; Yves Boucher; Noah C Choi; Douglas Mathisen; John Wain; Eugene J Mark; Lance L Munn; Rakesh K Jain Journal: Science Date: 2002-04-25 Impact factor: 47.728
Authors: Sang Min Lee; Se Hyung Kim; Jeong Min Lee; Seock-Ah Im; Yung-Jue Bang; Woo Ho Kim; Min A Kim; Han-Kwang Yang; Hyuk-Joon Lee; Won Jun Kang; Joon Koo Han; Byung Ihn Choi Journal: Abdom Imaging Date: 2009-07