| 1. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin 2024;74:12-49. |
Review/Other-Dx |
N/A |
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence and outcomes using incidence data collected by central cancer registries (through 2020) and mortality data collected by the National Center for Health Statistics (through 2021). In 2024, 2,001,140 new cancer cases and 611,720 cancer deaths are projected to occur in the United States. Cancer mortality continued to decline through 2021, averting over 4 million deaths since 1991 because of reductions in smoking, earlier detection for some cancers, and improved treatment options in both the adjuvant and metastatic settings. However, these gains are threatened by increasing incidence for 6 of the top 10 cancers. Incidence rates increased during 2015-2019 by 0.6%-1% annually for breast, pancreas, and uterine corpus cancers and by 2%-3% annually for prostate, liver (female), kidney, and human papillomavirus-associated oral cancers and for melanoma. Incidence rates also increased by 1%-2% annually for cervical (ages 30-44 years) and colorectal cancers (ages <55 years) in young adults. Colorectal cancer was the fourth-leading cause of cancer death in both men and women younger than 50 years in the late-1990s but is now first in men and second in women. Progress is also hampered by wide persistent cancer disparities; compared to White people, mortality rates are two-fold higher for prostate, stomach and uterine corpus cancers in Black people and for liver, stomach, and kidney cancers in Native American people. Continued national progress will require increased investment in cancer prevention and access to equitable treatment, especially among American Indian and Alaska Native and Black individuals. |
No results stated in abstract. |
4 |
| 2. Oliveira C, Pinheiro H, Figueiredo J, Seruca R, Carneiro F. Familial gastric cancer: genetic susceptibility, pathology, and implications for management. Lancet Oncol 2015;16:e60-70. |
Review/Other-Dx |
N/A |
In this Review, we discuss the available knowledge on hereditary gastric cancer and cancer-associated syndromes from which gastric cancer can arise, with the aim of clarifying questions relevant for the translation of basic research into clinical practice. |
N/A |
4 |
| 3. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11-20. |
Experimental-Tx |
250 patients with perioperative chemotherapy; 253 patients with surgery alone. |
To assess whether the addition of a perioperative regimen of ECF to surgery improves outcomes among patients with potentially curable gastric cancer. |
ECF-related adverse effects were similar to those previously reported among patients with advanced gastric cancer. Rates of postoperative complications were similar in the perioperative-chemotherapy group and the surgery group (46 percent and 45 percent, respectively), as were the numbers of deaths within 30 days after surgery. The resected tumors were significantly smaller and less advanced in the perioperative-chemotherapy group. With a median follow-up of four years, 149 patients in the perioperative-chemotherapy group and 170 in the surgery group had died. As compared with the surgery group, the perioperative-chemotherapy group had a higher likelihood of overall survival (hazard ratio for death, 0.75; 95 percent confidence interval, 0.60 to 0.93; P=0.009; five-year survival rate, 36 percent vs. 23 percent) and of progression-free survival (hazard ratio for progression, 0.66; 95 percent confidence interval, 0.53 to 0.81; P<0.001). |
1 |
| 4. Sando AD, Fougner R, Gronbech JE, Bringeland EA. The value of restaging CT following neoadjuvant chemotherapy for resectable gastric cancer. A population-based study. World J Surg Oncol. 19(1):212, 2021 Jul 13. |
Observational-Dx |
Of 171 patients receiving NAC, 169 were available for response evaluation |
The aim of this study was to investigate the value of UICC-downstaging as mode of response evaluation following a MAGIC-style regimen of NAC. |
Of 171 patients receiving NAC, 169 were available for response evaluation. For TNM-stages, 43% responded, 50% had stable disease and 7% progressed at CT. Crosstabulating yrTNM stage to ypTNM stage, 24% had concordant stages, with CT overstaging 38% and understaging 38% of the tumours, Cohen kappa ? = 0,06 (95%CI 0.004–0.12). Similar patterns of discordance were found for T-stages and N-stages separately. For M-category, restaging CT detected 12 patients with carcinomatosis, with an additional 14 diagnosed with carcinomatosis only at operation. No patient developed parenchymal or extra abdominal metastases, and none developed locally non-resectable tumour during delivery of NAC. Restaging CT with response evaluation was not able to stratify patients into groups of different long-term survival rates based on response mode. |
3 |
| 5. Blank S, Lordick F, Bader F, et al. Post-therapeutic response evaluation by a combination of endoscopy and CT scan in esophagogastric adenocarcinoma after chemotherapy: better than its reputation. Gastric Cancer. 18(2):314-25, 2015 Apr. |
Observational-Dx |
686 patients from Center A and 184 patients from Center B |
To evaluate the prognostic and predictive value of clinical response in esophagogastric adenocarcinomas. |
In A, 479 patients (70%) were defined as clinical nonresponders, 207 (30%) as responders. Median survival was 38 months (nonresponders: 27 months, responders: 108 months, log-rank, p < 0.001). Clinical and histopathological response correlated significantly (p < 0.001). In multivariate analysis, clinical response was an independent prognostic factor (HR for death 1.4, 95% CI 1.0-1.8, p = 0.032). In B, 140 patients (76%) were nonresponders and 44 (24%) responded. Median survival was 33 months, (nonresponders: 27 months, responders: not reached, p = 0.003). Interim clinical response evaluation (118 patients) also had prognostic impact (p = 0.008). Interim, preoperative clinical response and histopathological response correlated strongly (p < 0.001). |
4 |
| 6. Yardimci AH, Sel I, Bektas CT, et al. Computed tomography texture analysis in patients with gastric cancer: a quantitative imaging biomarker for preoperative evaluation before neoadjuvant chemotherapy treatment. Jpn J Radiol. 2020 Jun;38(6):553-560. |
Observational-Dx |
114 |
The aim of the study is to explore the role of computed tomography texture analysis (CT-TA) for predicting clinical T and N stages and tumor grade before neoadjuvant chemotherapy treatment in gastric cancer (GC) patients during the preoperative period. |
Dimension-reduction steps yielded five textural features for T stage, three for N stage and two for tumor grade. The discriminatory capacities of T stage, N stage and tumor grade were 90.4%, 81.6% and 64.5%, respectively, when LDA algorithm was employed. |
2 |
| 7. Sun Z, Li J, Wang T, Xie Z, Jin L, Hu S. Predicting perigastric lymph node metastasis in gastric cancer with CT perfusion imaging: A prospective analysis. Eur J Radiol. 2020 Jan;122():S0720-048X(19)30403-6. |
Observational-Dx |
115 |
To evaluate the diagnostic efficacy in differentiating metastatic from inflammatory perigastric lymph nodes (LNs) in patients with gastric cancer by using CT perfusion imaging (CTPI). |
The mean values of perfusion parameters and the short/long axis diameters ratio in metastatic and inflammatory LNs, respectively, were BF of 91.64 vs. 79.35 ml/100 mg /min (p < 0.01), PS of 43.42 vs. 35.92 ml/100 mg /min (p < 0.01), and the size ratio of 0.75 vs. 0.68 (p < 0.01). The sensitivity of 85.3%, specificity of 66.0 % and AUC of 0.816 for BF with cutoff value of 80.76 ml/100 mg /min for differentiating metastatic from inflammatory nodes were higher than those of PS or the size of LNs (p < 0.05). |
2 |
| 8. Li R, Li J, Wang X, Liang P, Gao J. Detection of gastric cancer and its histological type based on iodine concentration in spectral CT. Cancer Imaging. 2018 Nov 09;18(1):42. |
Observational-Dx |
87 gastric adenocarcinoma patients and 36 patients with benign gastric wall lesions |
To prospectively explore the ability of quantitative spectral CT parameters in the detection of gastric cancer and its histologic types. |
An excellent interobserver agreement (ICC > 0.6) was achieved for IC. Notably, the values of ICAP, ICPP, nICAP and nICPP were significantly higher in gastric cancer group (Z = 5.870, 3.894, 2.009 and 10.137, respectively; P < 0.05) than those in benign lesion group. Additionally, the values of ICAP, ICPP, nICAP and nICPP were significantly higher in poorly differentiated gastric adenocarcinoma group (Z = 4.118, 5.637, 6.729 and 2.950, respectively; P < 0.005) than those in well-differentiated gastric adenocarcinoma group. There were no statistically significant differences in the values of ICAP, ICPP, nICAP and nICPP between age, gender, tumor thickness and tumor location. Furthermore, the area under the curve (AUC) values of ICAP, nICAP, ICPP and nICPP were 0.745, 0.584, 0.662, and 0.932, respectively, for gastric cancer detection; while 0.756, 0.919, 0.851 and 0.684, respectively, in discriminating poorly differentiated gastric adenocarcinoma. |
3 |
| 9. Cheng SM, Ling W, Zhu J, Xu JR, Wu LM, Gong HX. Dual Energy Spectral CT Imaging in the assessment of Gastric Cancer and cell proliferation: A Preliminary Study. Sci Rep. 2018 Dec 04;8(1):17619. |
Review/Other-Dx |
N/A |
To obtain many quantitative measurements from iodine-based material decomposition (MD) images. |
No results stated in abstract. |
4 |
| 10. Li C, Shi C, Zhang H, Hui C, Lam KM, Zhang S. Computer-aided diagnosis for preoperative invasion depth of gastric cancer with dual-energy spectral CT imaging. Acad Radiol. 2015 Feb;22(2):S1076-6332(14)00313-4. |
Observational-Dx |
30 patients with gastric cancer |
To evaluate the accuracy of dual-energy spectral computed tomography (DEsCT) imaging with the aid of computer-aided diagnosis (CAD) system in assessing serosal invasion in patients with gastric cancer. |
Statistical analysis showed that for the collected cases, the feature "long axis" was significantly different between group A (serosa negative) and group B (serosa positive) (P < .05). By adding quantitative spectral features from several regions of interest (ROIs), the total classification accuracy was improved from 83.33% to 90.00%. Two feature ranking algorithms were used in the CAD scheme to derive the top-ranked features. The results demonstrated that low single-energy (approximately 60 keV) CT values, tumor size (long axis and short axis), iodine (water) density, and Effective-Z values of ROIs were important for classification. These findings concurred with the experience of the radiologist. |
3 |
| 11. Li C, Shi C, Zhang H, Chen Y, Zhang S. Multiple instance learning for computer aided detection and diagnosis of gastric cancer with dual-energy CT imaging. J Biomed Inform. 2015 Oct;57():S1532-0464(15)00185-9. |
Review/Other-Dx |
N/A |
To propose a novel multiple instance learning method for the identification of tumor invasion depth of gastric cancer with dual-energy CT imaging. |
No results stated in abstract. |
4 |
| 12. Miedzybrodzki K, Zaleska-Dorobisz U, Slonina J, et al. Usefulness of conventional and low-dose hydro-CT in the diagnosis of gastric tumors in comparison to endoscopy. European Journal of Radiology. 93:90-94, 2017 Aug. |
Observational-Dx |
27 male, 13 female |
The aim of this retrospective study was to evaluate the usefulness of hydro-computed tomography (CT) in the diagnosis of gastric tumors in comparison to endoscopy. |
Histopathology confirmed the presence of gastric cancer in 28 patients (70%), while gastrointestinal stromal tumors (GISTs) were recognized in the remaining 12 cases (30%). Correct diagnoses of the type of gastric tumor in hydro-CT were obtained in 37 patients (92.5%). This was not significantly different from the 85% accuracy of endoscopy. Further analysis showed that the correctness of GIST diagnosis in endoscopy and hydro-CT also did not differ significantly (91.7% and 100% respectively). The percentage of correctly diagnosed malignant lesions in hydro-CT was lower than for GISTs at 89.29%, while in endoscopy it was insignificantly lower (82.14%). The diagnostic accuracy of conventional and low-dose hydro-CT in the diagnosis of gastric tumors (95% and 90% respectively) was not significantly different. |
3 |
| 13. Kim JW, Shin SS, Heo SH, et al. The role of three-dimensional multidetector CT gastrography in the preoperative imaging of stomach cancer: emphasis on detection and localization of the tumor. Korean J Radiol. 2015;16(1):80-9. |
Review/Other-Dx |
N/A |
To discuss technical factors in producing high-quality MDCT gastrographic images and present cases demonstrating the usefulness of MDCT gastrography for the detection and T staging of gastric cancer while emphasizing the significance of preoperative localization of gastric cancer in terms of surgical margin. |
No results stated in abstract. |
4 |
| 14. Wang L, Jin X, Qiao Z, Xu B, Shen J. The Value of Low-dose Prospective Dual-energy Computed Tomography with Iodine Mapping in the Diagnosis of Gastric Cancer. Current Medical Imaging. 16(4):433-437, 2020. |
Observational-Dx |
60 patients (Group A = 30 patients single contrast-enhanced abdominal CT using a dual-source; Group B = 30 patients with standard CT |
To investigate the radiation dose and value of prospective dualenergy computed tomography (DECT) in the diagnosis of gastric cancer. |
During the blinded read, observers found 90% (27/30) of the cancers in both groups. The mean imaging quality scores were 2.1±0.9 for Group A, and 2.3±1.1 for Group B. The effective mean doses were 6.59±0.59 mSv and 25.86±0.44 mSv for Groups A and B, respectively. Compared with the control group (B), the imaging quality in the low-dose group decreased a little, but the radiation dose substantially decreased by 74.6%. |
1 |
| 15. Ma Q, Xin J, Zhao Z, et al. Value of 18F-FDG PET/CT in the diagnosis of primary gastric cancer via stomach distension. European Journal of Radiology. 82(6):e302-6, 2013 Jun. |
Observational-Dx |
56 malignant gastric neoplasm patients |
To clarify the usefulness of (18)F-FDG PET/CT for detecting primary gastric cancer via gastric distention using a mixture of milk and Diatrizoate Meglumine. |
Of the 68 patients, 56 malignant gastric neoplasm patients (male: 37, female: 19) were conformed. The sensitivity, specificity, positive predictive value and negative predictive value of fasting whole-body PET/CT imaging for a primary malignant tumor were 92.9%, 75.0%, 94.5%, and 69.0%, respectively. The values for distension with a mixture of milk and Diatrizoate Meglumine were 91.1%, 91.7%, 98.1%, and 68.8%, respectively. The area under the curve was 0.919 ± 0.033 and 0.883 ± 0.066 for the diagnosis of gastric cancer with SUVmax in a fasting state and after intake of mixture respectively, the differences were not statistically significant (P=0.359). Using gastric distension with a mixture of milk and Diatrizoate Meglumine, the mean ratio of the lesion's SUVmax to the adjacent gastric wall SUVmax increased significantly from 3.30 ± 3.05 to 13.50 ± 15.05, which was statistically significant (P<0.001). |
3 |
| 16. Tomizawa M, Shinozaki F, Uchida Y, et al. Diffusion-weighted whole-body imaging with background body signal suppression/T2 image fusion and positron emission tomography/computed tomography of upper gastrointestinal cancers. Abdominal Imaging. 40(8):3012-9, 2015 Oct. |
Review/Other-Dx |
14 patients |
To compare DWIBS/T2 and PET/CT in patients with upper gastrointestinal cancers. |
Six out of eight patients with gastric cancer had positive results on both DWIBS/T2 and PET/CT. The diameter and depth of invasion of gastric cancer was larger in patients with positive DWIBS/T2 and PET/CT findings than those with negative findings. These results suggested that patients with gastric cancer with larger pixel numbers might tend to show positive results with DWIBS/T2. |
4 |
| 17. Cui J, Zhao P, Ren Z, Liu B. Evaluation of Dual Time Point Imaging 18F-FDG PET/CT in Differentiating Malignancy From Benign Gastric Disease. Medicine. 94(33):e1356, 2015 Aug. |
Observational-Dx |
74 |
To assess the clinical value of dual time point imaging (DTPI) fluorine-18fludeoxyglucose (18F-FDG) positron emission tomography (PET)/CT in differentiating malignancy and benign disease of patients with focally increased gastric uptake. |
The S1 was 5.0 ± 1.4 (range, 1.9–11.3), and S2 was 5.9 ± 2.7 (range, 1.0–16.3). The SUVmax were increased in 52 patients in delayed imaging, with 85% (44/52 cases) appeared malignant; decreased in 20 patients, and 90% (18/20 cases) were benign; 2 patients of benign had not changed. The change of SUVmax between malignant and benign was significant difference (t = -5.785, P = 0.000).Taking the S1, S2, and RI higher than 4.6%, 5.1%, and 13% as positive diagnostic criteria, the sensitivity were 65.2%,87.0%, and 87.0%, respectively; the specificity were 64.3%, 82.1%, and 89.3%; the Youden index were 0.332, 0.693, and 0.770; AUC were 0.635 (95% confidence intervals (95% CI) 0.507–0.764), 0.873 (95% CI, 0.786–0.961), and 0.923 (95% CI, 0.854–0.992). |
2 |
| 18. Minamimoto R, Senda M, Jinnouchi S, Terauchi T, Yoshida T, Inoue T. Performance profile of a FDG-PET cancer screening program for detecting gastric cancer: results from a nationwide Japanese survey. Japanese Journal of Radiology. 32(5):253-9, 2014 May. |
Observational-Dx |
153,775 subjects |
To analyze the detection rate and the effectiveness of the FDG-PET cancer screening program at detecting gastric cancer between 2006 and 2009 in Japan. |
The number of cases who were verified to have gastric cancer was 124. Among these, only 47 cases were detected by FDG-PET, which resulted in a relative sensitivity of 37.9% and a positive predictive value of 33.6%. The relative sensitivity of FDG-PET was much lower than those of gastric endoscopy and the serum pepsinogen test. |
4 |
| 19. Wang Y, Luo W, Li Y. [68Ga]Ga-FAPI-04 PET MRI/CT in the evaluation of gastric carcinomas compared with [18F]-FDG PET MRI/CT: a meta-analysis. [Review]. European Journal of Medical Research. 28(1):34, 2023 Jan 18. |
Meta-analysis |
Five studies, including 148 participants |
To compare the detection rates of [68Ga]Ga-FAPI-04 PET MRI/CT vs. [18F]-FDG PET MRI/CT in gastric cancer. |
Five studies, including 148 participants, were analyzed. [68Ga]Ga-FAPI-04 PET MRI/CT has a comparatively high sensitivity in patient-based evaluations compared with [18F]-FDG PET MRI/CT (risk difference = 0.16, 95% CI 0.09-0.22, P < 0.00001). The [68Ga]Ga-FAPI-04 PET MRI/CT group has a comparatively higher sensitivity in detecting lymph node metastases (RR = 0.15, 95% CI 0.01-0.29, P = 0.04), peritoneal involvement (RR = 0.55, 95% CI 0.38-0.72, P < 0.00001) in gastric cancer than [18F]-FDG PET MRI/CT group. |
Good |
| 20. Jang KM, Kim SH, Lee SJ, Lee MW, Choi D, Kim KM. Upper abdominal gadoxetic acid-enhanced and diffusion-weighted MRI for the detection of gastric cancer: Comparison with two-dimensional multidetector row CT. Clinical Radiology. 69(8):827-35, 2014 Aug. |
Observational-Dx |
189 patients with 170 surgically confirmed gastric cancers and 19 patients without gastric cancer |
To evaluate the diagnostic performance of abdominal magnetic resonance imaging (MRI) for the detection of gastric cancer in comparison with that of two-dimensional (2D) multidetector row computed tomography (CT). |
The diagnostic accuracy and sensitivity for detection of gastric cancer were significantly higher on combined conventional and DW MRI set (77.8-78.3%; 75.3-75.9%) than the CT imaging set (67.7-71.4%; 64.1-68.2%) or the conventional MRI set (72-73%; 68.8-70%; p < 0.01). In particular, for gastric cancers with pT2 and pT3, the combined conventional and DW MRI set (91.6-92.6%) yielded significantly higher sensitivity for detection of gastric cancer than did the CT imaging set (76.8-81.1%) by both observers (p < 0.01). The mean ADC of gastric cancer lesions (1 ± 0.23 × 10(-3) mm(2)/s) differed significantly from that of normal gastric wall (1.77 ± 0.25 × 10(-3) mm(2)/s; p < 0.01). |
3 |
| 21. Li Q, Xu WY, Sun NN, et al. MRI versus Dual-Energy CT in Local-Regional Staging of Gastric Cancer. Radiology 2024;312:e232387. |
Observational-Dx |
202 participants |
To compare the diagnostic accuracy of personalized mpMRI with that of DECT for local-regional T and N staging in patients with GC receiving curative surgical intervention. |
This study included 202 participants (mean age, 62 years ± 11 [SD]; 145 male). The interreader agreement of the six readers for T and N staging of GC was excellent for both mpMRI (? = 0.89 and 0.85, respectively) and DECT (? = 0.86 and 0.84, respectively). Regardless of reader experience, higher accuracy was achieved with mpMRI than with DECT for both T (61%-77% vs 50%-64%; all P < .05) and N (54%-68% vs 51%-58%; P = .497-.005) staging, specifically T1 (83% vs 65%) and T4a (78% vs 68%) tumors and N1 (41% vs 24%) and N3 (64% vs 45%) nodules (all P < .05). |
1 |
| 22. Li M, Zheng G, Yu L, et al. Diagnostic value of MRI-DWI signal intensity value combined with serum PGI, PGII and CA199 in early gastric cancer. Cellular & Molecular Biology. 67(2):95-100, 2021 Aug 31. |
Observational-Dx |
60 cases of gastric cancer patients and 80 cases of healthy volunteers |
To explore the diagnostic value of MRI-DWI signal intensity value combined with serum PGI. PGII and CA199 in early gastric cancer. |
In the healthy group, T1W1 showed relatively uniform low signal intensity. While T2WI showed no significant increase in signal intensity. In the gastric cancer group. There was diffuse gastric wall thickening, local thickening or mass formation; T1WI and WATS showed slightly lower signal intensity in the lesion area. T2WI, FLAIR and B-TFE showed slightly uneven or moderately increased signal intensity. DWI showed limited diffusion, and the signal intensity increased uniformly or more uniformly, and the range of increase was clear. The signal intensity of MRI-DWI was 89.12 ± 8.14 in patients with low differentiation, 82.17 ± 6.35 in patients with moderate differentiation, and 74.52 ± 4.53 in patients with high differentiation. There were significant differences in the signal intensity of MRI-DWI among the three groups, and the difference was statistically significant (F=12.214, P <0.05). Serum PGI levels of subjects in the gastric cancer group were significantly lower than those in the healthy group, and the levels of PGII and CA199 were significantly higher than that in the healthy group, with statistical significance (P <0.05). The AUC, sensitivity and specificity of MRI-DWI signal intensity value and serum PGI, PGII and CA199 combined indexes in the diagnosis of gastric cancer were significantly higher than those of the independent indexes, with statistical significance (P <0.05). |
2 |
| 23. Xiong J, Jiang J, Chen Y, Chen Y, Xie C, Xu S. Application of Endoscopic Ultrasound Combined with Multislice Spiral CT in Diagnosis and Treatment of Patients with Gastrointestinal Eminence Lesions. Disease Markers. 2022:1417104, 2022. |
Observational-Dx |
160 patients |
To evaluate the application of endoscopic ultrasound (EUS) combined with multislice spiral CT (MSCT) in the diagnosis and treatment of patients with gastric eminence lesions. |
The common pathological types of gastric eminence lesions include polyps and stromal tumors, with the most common sites of lesions in the gastric antrum, followed by the fundus of the stomach and the gastric body. Gastric eminence lesions mostly originate from the mucosal layer and muscularis mucosa, accounting for 83.13% of the total. With pathological results as the gold standard, the detection rate of MSCT was 90.63%, and that of EUS was 78.13%. With the joint diagnosis as a reference, the receiver operating curve (ROC) revealed a higher diagnostic efficiency of MSCT and EUS. |
3 |
| 24. Liu L, Lu DY, Cai JR, Zhang L. The value of oral contrast ultrasonography in the diagnosis of gastric cancer in elderly patients. World Journal of Surgical Oncology. 16(1):233, 2018 Dec 07. |
Observational-Dx |
196 patients |
This study aims to investigate the value of oral contrast ultrasonography (OCUS) in the diagnosis of gastric cancer in elderly patients. |
Among the 12,716 subjects examined by OCUS, 5021 subjects were = 60 years old, which accounted for 39.48% (5021/12,716). Gastritis, gastric polyp, benign ulcer, and gastric cancer were detected by OCUS in 1099 patients. Among them, 196 patients underwent gastroscopy. Furthermore, ulcerative lesions were detected in 32 patients by OCUS and in 51 patients by gastroscopy, and the coincidence rate was 62.74%. Among these patients, gastric cancer was diagnosed in 18 patients by OCUS with a detection rate of 1.64% (18/1099) and detected in 19 patients by gastroscopy with a diagnostic coincidence rate of 94.73% (18/19). Furthermore, benign ulcer was detected in 14 patients by OCUS and in 32 patients by gastroscopy, and the diagnostic coincidence rate was 43.75% (14/32). |
3 |
| 25. He P, Miao LY, Ge HY, et al. Preoperative Tumor Staging of Gastric Cancer: Comparison of Double Contrast-Enhanced Ultrasound and Multidetector Computed Tomography. J Ultrasound Med. 2019 Dec;38(12):3203-3209. |
Observational-Dx |
54 |
To compare the sensitivity and specificity of double contrast-enhanced ultrasound (CEUS) and multidetector computed tomography (MDCT) in the preoperative tumor staging of gastric cancer (GC) to stratify patients for suitable treatment. |
There were no significant differences in AUC values for T1 and T2 stages between double CEUS and MDCT (P = .190 and .256, respectively). However, the sensitivity of double CEUS in the detection of the T1 stage was higher than that of MDCT (88% versus 75%). The AUC values of MDCT for T3 and T4 stages were 0.833 and 0.905, which were both significantly higher than those of double CEUS (0.759 and 0.696; P?<?.05). The sensitivities of double CEUS and MDCT for the T3 stage were both 89%, but the accuracy and specificity of double CEUS were lower than those of MDCT (76% versus 83% and 63% versus 78%). The specificities of double CEUS and MDCT for the T4 stage were both 98%, but the accuracy and sensitivity of double CEUS were lower than those of MDCT (85% versus 94% and 42% versus 83%). |
2 |
| 26. Jiang M, Wang X, Shan X, et al. Value of multi-slice spiral computed tomography in the diagnosis of metastatic lymph nodes and N-stage of gastric cancer. Journal of International Medical Research. 47(1):281-292, 2019 Jan. |
Observational-Dx |
91 |
To establish new diagnostic criteria for improvement of the accuracy of multi-slice spiral computed tomography (MSCT) in diagnosing the N-stage and lymph node (LN) metastasis of gastric cancer (GC). |
Application of the combined diagnostic criteria increased the diagnostic performance of MSCT in not only judging the N-stage but also diagnosing LN metastasis. The accuracy of MSCT in diagnosing the N-stage as a whole was 86.3%, and that in diagnosing LN metastasis was 79.1% to 98.9%. The Kappa values for stages N0, N1, and N3 ranged from 0.449 to 0.662, indicating good consistency in diagnosing these three stages between MSCT and the postsurgical pathological results. The Ktotal value was 0.567 between MSCT and the postsurgical pathological results in diagnosing LN metastasis. The risk of LN metastasis increased with the progression of lesion infiltrates. |
3 |
| 27. Ri M, Yamashita H, Gonoi W, et al. Identifying multiple swollen lymph nodes on preoperative computed tomography is associated with poor prognosis along with pathological extensive nodal metastasis in locally advanced gastric cancer. European Journal of Surgical Oncology. 48(2):377-382, 2022 Feb. |
Observational-Dx |
421 patients with pT2-4 gastric carcinoma |
To determine whether the number and size of lymph nodes (LN) depicted by preoperative multi-detector row computed tomography (MDCT) correlate with pathological nodal status, as well as examining the survival impact of clinical nodal staging, in patients with locally advanced gastric cancer. |
The PPV for detecting pN2/3 disease rose with the SAD value cut-off for one LN, reaching 84.6% at 10 mm with no further increase at 15 mm. However, the SAD cut-off value plateaued at 8 mm (91.3%) when at least two measurable LNs were identified on MDCT. Patients with two measurable LNs with SAD=8 mm had significantly poorer 5-year overall and recurrence-free survival than patients with fewer than two measurable LNs in the pN2-3 disease. On multivariate analysis, two measurable LNs with SAD=8 mm was an independent prognostic factor for overall and relapse-free survivals. |
3 |
| 28. Wang Z, Liu Q, Zhuang X, et al. pT1-2 gastric cancer with lymph node metastasis predicted by tumor morphologic features on contrast-enhanced computed tomography. Diagnostic & Interventional Radiology. 29(2):228-233, 2023 03 29. |
Observational-Dx |
86 patients with pT1-2 gastric cancer (GC) |
To investigate the value of tumor morphologic features of pT1-2 gastric cancer (GC) on contrast-enhanced computed tomography (CT) in assessing lymph node metastasis (LNM) with reference to histopathological results. |
Tumor volume, CT density in the PVP, and tumor percent enhancement in the PVP correlated significantly with the N stage (rho: 0.307, 0.558, and 0.586, respectively). Tumor volumes were significantly lower in the LNM- group than in the LNM+ group (14.4 mm3 vs. 22.6 mm3, P = 0.004). The differences between the LNM- and LNM+ groups in the CT density in the PVP and the percent enhancement in the PVP were also statistically significant (68.00 HU vs. 87.50 HU, P < 0.001; and 103.06% vs. 179.19%, P < 0.001, respectively). The area under the ROC curves for identifying the LNM+ group was 0.69 for tumor volume and 0.88 for percent enhancement in the PVP, respectively. The percent enhancement in the PVP of 145.2% and tumor volume of 17.4 mL achieved good diagnostic performance in determining LNM+ (sensitivity: 71.4%, 82.1%; specificity: 91.4%, 58.6%; and accuracy: 84.9%, 66.3%, respectively). |
3 |
| 29. Luo M, Lv Y, Guo X, Song H, Su G, Chen B. Value and impact factors of multidetector computed tomography in diagnosis of preoperative lymph node metastasis in gastric cancer: A PRISMA-compliant systematic review and meta-analysis. [Review]. Medicine. 96(33):e7769, 2017 Aug. |
Meta-analysis |
6519 |
This present meta-analysis was carried out to evaluate the value of multidetector computed tomography (MDCT) in diagnosis of preoperative lymph node metastasis (LNM) and to explore the impact factors that might explain the heterogeneity of its diagnostic accuracy in gastric cancer. |
A total of 27 studies with 6519 subjects were finally included. Overall, the pooled sensitivity, specificity, and AUC were 0.67 (95% CI: 0.56–0.77), 0.86 (95% CI: 0.81–0.90), and 0.86 (95% CI: 0.83–0.89), respectively. Meta-regression revealed that MDCT section thickness, proportion of serosal invasion, and publication year were the main significant impact factors in sensitivity, and MDCT section thickness, multiplanar reformation (MPR), and reference standard were the main significant impact factors in specificity. After the included studies were divided into 2 groups (Group A: studies with proportion of serosa-invasive GC subjects =50%; Group B: studies with proportion of serosa-invasive GC subjects <50%), the pooled sensitivity in Group A was significantly higher than in Group B (0.84 [95% CI: 0.75–0.90] vs 0.55 [95% CI: 0.41–0.68], P < .01). For early gastric cancer (EGC), the pooled sensitivity, specificity, and AUC were 0.34 (95% CI: 0.15–0.61), 0.91 (95% CI: 0.84–0.95), and 0.83 (95% CI: 0.80–0.86), respectively. |
Good |
| 30. Wu LL, Xin JY, Wang JJ, Feng QQ, Xu XL, Li KY. Prospective Comparison of Oral Contrast-Enhanced Transabdominal Ultrasound Imaging With Contrast-Enhanced Computed Tomography in Pre-operative Tumor Staging of Gastric Cancer. Ultrasound in Medicine & Biology. 49(2):569-577, 2023 02. |
Observational-Dx |
108 |
The aim of this prospective study was to compare the diagnostic accuracy of oral contrast-enhanced transabdominal ultrasound imaging (OCTU) with that of contrast-enhanced computed tomography (CT) for the pre-operative tumor staging of gastric cancer, with post-operative pathology as the standard. We included 108 cases of gastric cancer with simultaneous OCTU and enhanced CT pre-operative tumor staging diagnoses. |
There were 126 cases with complete pathological staging data and OCTU and enhanced CT images with acceptable image quality. The overall, early and advanced detection rates of the 126 cases of gastric can-cer were 93.6%, 77.8% and 100% by OCTU and 86.5%, 55.6% and 98.9% by enhanced CT, respectively. For OCTU, the overall rates of detection of gastric cancer and early gastric cancer were higher than those of enhanced CT, and the difference was statistically signi?-cant. The detailed detection rates of the two imaging modalities in each period are summarized in Table 1. During diagnosis of the 126 cases, 8 were unclear on OCTU, 17 were unclear on CT and 7 were unclear on both. Finally, 108 patients with comparable stages were included.A total of 108 patients (79 men and 29 women, mean age: 61.7§11.2 y, age range: 2787 y, mean BMI: 22.4 § 3.2 kg/m2, BMI range: 15.333.1 kg/m2) were enrolled in this prospective comparative study. The main locations of intra-operative combined gastroscopy lesions were the cardia (15 cases), the gastric fundus (9 cases), the gastric body (33 cases), the gastric angle (14 cases) and the gastric antrum (37 cases).The pathological features were adenocarcinoma in 103 cases and other types of cancer in 5 cases. There were 19 cases of early gastric cancer with tumor invasion depth limited to the submucosa and 89 cases of advanced gastric cancer (Table 2).OCTU (72.2% [78/108]) and enhanced CT (75.9%[82/108], p = 0.644) were comparable in accuracy for the overall T staging diagnosis of gastric cancer. The accuracy of OCTU in stage T1 gastric cancer was better than that of enhanced CT (p = 0.031), and the accuracy of OCTU in stage T2 was also slightly better than that of enhanced CT; however, the differences were not statisti-cally signi?cant (p > 0.999). Furthermore, the accuracy of enhanced CT in stage T3 gastric cancer was better than that of OCTU (p = 0.049), and the accuracy of CT in stage T4 was also better than that of OCTU, but there were no signi?cant differences (p = 0.804). Comparisons of the diagnostic accuracy of OCTU and enhanced CT at each tumor stage are outlined in Table 3.In early gastric cancer, OCTU classi?ed 2 cases of T1 disease as T2 and 1 case of T1 as T3. Enhanced CT classi?ed 7 cases of T1 as T2 and 2 cases of T1 as T3. Both OCTU and enhanced CT classi?ed 1 case of T1 as T3. The pathology of this case indicated that the cancer was con?ned to the submucosa, while the accompanying ulcer reached the subserosal layer. Among advanced gas-tric cancers, OCTU judged 10 cases of tumor invasion depth too deeply and 17 cases too shallowly, and enhanced CT judged 6 too deeply and 11 too shallowly (Table 4). Images of the OCTU and enhanced CT T1T4 stages are provided in Figures 2-5. |
2 |
| 31. Girolamo MDI, Carbonetti F, Bonome P, Grossi A, Mazzuca F, Masoni L. Hydro-MDCT for Gastric Adenocarcinoma Staging. A Comparative Study With Surgical and Histopathological Findings for Selecting Patients for Echo-endoscopy. Anticancer Res 2020;40:3401-10. |
Review/Other-Dx |
65 patients |
to evaluate the accuracy of hydro-multidetector-computed tomography (hydro-MDCT) in the evaluation of gastric adenocarcinomas with subsequent surgical and histopathological correlation to select cases for echo-endoscopy. |
Hydro-MDCT always detected gastric cancer and in 49/65 patients the assessment of T-parameter was identical to the histopathological results (accuracy: 75%). We found overstaging in 12 and understaging in 4 cases. N-parameter with MDCT was in agreement with histo-pathology in 69%of patients; in metastatic disease hydro-MDCT had an accuracy of 99%. Hydro-MDCT has proven to be a reliable diagnostic technique in evaluating gastric cancer T3-T4 stages in comparison to T1 and T2: in defining T2-stage we found the highest number of errors (37%). |
4 |
| 32. Fujikawa H, Yoshikawa T, Hasegawa S, et al. Diagnostic value of computed tomography for staging of clinical T1 gastric cancer. Annals of Surgical Oncology. 21(9):3002-7, 2014 Sep. |
Observational-Dx |
761 patients |
To show taht multidetector-row computed tomography (CT) evaluation is valuable for clinical T1 patients. |
A total of 761 patients, 236 treated by ESD and 525 treated with surgery, were examined. None of the patients had an endoscopic diagnosis of clinical T1 reversed by CT. No clinical M1 disease was found. Among the 525 patients who underwent surgery, 8 showed clinical N+ disease (1.5 %), while 47 demonstrated pathological N+ disease (8.9 %). The accuracy, sensitivity, specificity, positive predictive value, and negative predictive values were 90.3, 4.3, 98.7, 25, and 91.3 %, respectively. The 5-year DFS rate was 93.6 % (95 % confidence interval 91.4-95.8 %). |
3 |
| 33. Li J, Tan Y, Zhang D, et al. Value and necessity of pelvic CT in gastric cancer staging: an observational study. Scandinavian Journal of Gastroenterology. 53(9):1097-1099, 2018 Sep. |
Review/Other-Dx |
227 GC patients |
To evaluate the value and necessity of pelvic CT in routine GC staging. |
A total of 227 GC patients received abdominopelvic CT examinations at our institution. Of the patients, 22.0% (n = 50) had findings in the pelvis, and the most common was ascites (8.8%, n = 20). The metastatic diseases in pelvis were found in 2.2% (n = 5) of all patients, including peritoneal thickening with nodules, left adnexal solid masses, bladder wall mass, bone lesions, and lymphatic spread. The isolated pelvis metastasis was found in 1.3% (n = 3) of patients. |
4 |
| 34. You JM, Kim TU, Kim S, et al. Preoperative N stage evaluation in advanced gastric cancer patients using multidetector CT: can the sum of the diameters of metastatic LNs be used for N stage evaluation?. Clinical Radiology. 74(10):782-789, 2019 Oct. |
Observational-Dx |
127 consecutive patients who underwent preoperative MDCT and gastrectomy for AGC |
To compare the diagnostic performance of total counts of metastatic lymph nodes (LN-sum) and conventional multidetector (MD) computed tomography (CT) staging in the nodal evaluation of advanced gastric cancer (AGC) patients. |
The total counts of metastatic LNs on MDCT was significantly smaller than those detected in histopathological assessments (p<0.0001). LN-sum showed significant correlation with the pathological N stage and the number of metastatic LNs (rho=0.69, 0.73, p<0.0001). The areas under the receiver operating characteristic curve were 0.896, and 0.835, for N stage =N2 and N3, with cut-off values of 12.5 and 23.5 mm, respectively. LN-sum provided better diagnostic performance than conventional MDCT staging for discriminating N0-2 versus N3; sensitivity, accuracy, PPV and NPV of LN-sum were significantly higher (80.4 versus 52.2%, 81.1 versus 68.5%, 71.2 versus 57.1%, and 88 versus 74.1%). |
3 |
| 35. Kawaguchi T, Komatsu S, Ichikawa D, et al. Clinical significance and prognostic impact of the total diameter of enlarged lymph nodes on preoperative multidetector computed tomography in patients with gastric cancer. Journal of Gastroenterology & Hepatology. 30(11):1603-9, 2015 Nov. |
Observational-Dx |
70 patients with a preoperative diagnosis of nodal metastasis on MDCT |
To evaluate the clinical significance and prognostic impact of the total diameter of enlarged lymph nodes (TDL) on preoperative multidetector computed tomography (MDCT) in gastric cancer (GC). |
The TDL was calculated, and using a receiver operating characteristic curve, a cutoff value of 45 mm in the two groups of large TDL (LTDL) and small TDL was found to be appropriate for TDL. No significant differences were observed in clinicopathological features, except for tumor recurrence, between the two groups. Univariate survival analysis revealed that patients with LTDL had a worse prognosis as well as an upper tumor location, deeper tumor depth, and further advanced pathological stage. Multivariable prognostic analysis identified LTDL as an independent worse prognostic factor (P = 0.0128). |
2 |
| 36. Wada T, Yoshikawa T, Kamiya A, et al. A nodal diagnosis by computed tomography is unreliable for patients who need additional gastrectomy after endoscopic submucosal dissection. Surgery Today. 50(9):1032-1038, 2020 Sep. |
Observational-Dx |
650 patients |
Preoperative computed tomography (CT) after endoscopic submucosal dissection (ESD) sometimes reveals enlarged lymph nodes, which should prompt surgeons to select D2 over D1/D1+. However, whether or not CT after ESD is reliable remains unclear. |
A total of 650 patients (group A; 81, group B; 569) were examined. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value (group A vs. group B) were 77.8% vs. 84.2%, 0.0% vs. 15.9%, 84.0% vs. 95.7%, 0.0% vs. 38.2%, and 91.3% vs. 87.1%, respectively. The false-positive rate was 100% in group A and 61.8% in group B (p = 0.011). |
3 |
| 37. Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: a systematic review. J Clin Oncol 2007;25:2107-16. |
Review/Other-Dx |
22 EUS studies, 5 MDCT studies, 1 combined EUS/ MDCT study, 3 MRI studies |
To systematically review the literature regarding the performance of each of these imaging modalities. |
Twenty-two EUS studies, five MDCT studies, one combined EUS and MDCT study, and three MRI studies met the inclusion criteria. The studies were of moderate methodological quality. Diagnostic accuracy of overall T staging for EUS, MDCT, and MRI varied between 65% to 92.1%, 77.1% to 88.9%, and 71.4% to 82.6%, respectively. Sensitivity for assessing serosal involvement for EUS, MDCT, and MRI varied between 77.8% to 100%, 82.8% to 100%, and 89.5% to 93.1%, respectively. Specificity for assessing serosal involvement for EUS, MDCT, and MRI varied between 67.9% to 100%, 80% to 96.8%, and 91.4% to 100%, respectively. |
4 |
| 38. Hallinan JT, Venkatesh SK. Gastric carcinoma: imaging diagnosis, staging and assessment of treatment response. [Review]. Cancer Imaging. 13:212-27, 2013 May 30. |
Review/Other-Dx |
N/A |
To discuss the usefulness of imaging modalities for detecting, staging and assessing treatment response for GC and the potential role of newer applications including CT volumetry, virtual gastroscopy and perfusion CT in the management of GC. |
No results stated in abstract. |
4 |
| 39. Pongpornsup S, Neungton P, Chairoongruang S, Apisamrnthanarak P. Diagnostic performance of multidetector computed tomography (MDCT) in evaluation for peritoneal metastasis in gastric cancer. Journal of the Medical Association of Thailand. 97(8):863-9, 2014 Aug. |
Observational-Dx |
50 patients with gastric cancer who underwent MDCT |
To determine the characteristic imaging findings and accuracy for diagnosis of peritoneal metastasis in gastric cancer by 64-slice multidetector computed tomography (MDCT). |
Twenty-five patients from 50 patients indicated presence of peritoneal metastasis. The accuracies of 64-sliced MDCT of ascites, increased peritoneal fat density, peritoneal thickening/enhancement, and peritoneal nodule are 80.00, 80.00, 68.00, and 84.00%, respectively. |
3 |
| 40. Li ZY, Tang L, Li ZM, et al. Four-Point Computed Tomography Scores for Evaluation of Occult Peritoneal Metastasis in Patients with Gastric Cancer: A Region-to-Region Comparison with Staging Laparoscopy. Annals of Surgical Oncology. 27(4):1103-1109, 2020 Apr. |
Observational-Dx |
385 patients |
To explore the abnormal computed tomography (CT) signs of occult peritoneal metastasis (OPM) and evaluated it by region-to-region comparison using staging laparoscopy, from which a 4-point CT score system was developed. |
In this study, 57 OPM regions were detected by staging laparoscopy in 33 of the 385 enrolled patients. The greater omentum was the most frequent site of OPM (38.60%, 22/57), which usually exhibited a smudge-like ground-glass opacity (S-GGO) (90.91%, 20/22) with a mean CT score of 2.14. The parietal and perihepatic peritoneum was the second most common site (22.81%, 13/57). A 4-point CT score system was developed based on the results. A cutoff CT score of 2 or higher was associated with a false-negative rate of 2% (2/99). This CT score system had a sensitivity of 87.5% and a specificity of 76.4% for an OPM-positive diagnosis (area under the curve, 0.848). The agreement between two radiologists on the assigned final score was 76.2% (kappa, 0.5). |
2 |
| 41. Leeman MF, Patel D, Anderson J, O'Neill JR, Paterson-Brown S. Multidetector Computed Tomography Versus Staging Laparoscopy for the Detection of Peritoneal Metastases in Esophagogastric Junctional and Gastric Cancer. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 27(5):369-374, 2017 Oct. |
Observational-Dx |
75 patients |
To investigate whether computed tomography (CT) can replace staging laparoscopy (SL) in the detection of peritoneal metastases (PM). |
In total, 74 patients undergoing SL were included. Sensitivity and specificity of SL for PM were 94.1% (95% confidence interval, 69.2-99.7) and 100% (90.7-100). Sensitivity and specificity of CT were 58.8% (33.5-80.6) and 89.6% (76.6-96.1), respectively. Area under the curve of receiver operating characteristic curves for SL and CT were 0.971 (SE, 0.033) and 0.742 (SE, 0.78), respectively. |
3 |
| 42. Tian SF, Liu AL, Wang HQ, Liu JH, Sun MY, Liu YJ. Virtual non-contrast computer tomography (CT) with spectral CT as an alternative to conventional unenhanced CT in the assessment of gastric cancer. Asian Pacific Journal of Cancer Prevention: Apjcp. 16(6):2521-6, 2015. |
Review/Other-Dx |
52 patients |
To evaluate computed tomography (CT) virtual non-contrast (VNC) spectral imaging for gastric carcinoma. |
Carcinoma-water CNR values were significantly higher in VNCa, VNCv, and VNCe images than in normal CT images (2.72, 2.60, 2.61, respectively, vs 2.35, p=0.008). Carcinoma- perigastric fat CNR values were significantly lower in VNCa, VNCv, and VNCe images than in normal CT images (7.63, 7.49, 7.32, respectively, vs 8.48, p<0.001). There were no significant differences of carcinoma-water CNR and carcinoma-perigastric fat CNR among VNCa, VNCv, and VNCe images. There was no difference in the determination of invasion or enlarged lymph nodes between normal CT and VNCa images. |
4 |
| 43. Chong CS, Ng CW, Shabbir A, Kono K, So JB. Computed tomography of the thorax for gastric cancer staging: Is it necessary?. Scandinavian Journal of Surgery: SJS. 104(4):244-7, 2015 Dec. |
Review/Other-Dx |
808 cases |
Validity of the use of computed tomography thorax in gastric cancer staging has not been challenged. |
A total of 808 gastric cancer cases were reviewed. The mean age of the patients was 66 years (standard deviation 13.53), and 67% were male. In all, 238 patients (30%) had metastatic disease at presentation, and 1 (0.42%) had isolated lung metastasis. The most common site of metastasis was intra-abdominal (73.8%). Among the patients who underwent surgery, the overall distant recurrence rate was 30%, of which only 83 (30%) patients had lung metastasis and all had concurrent metastasis in an intra-abdominal site. |
4 |
| 44. Chen AH, Chan WH, Lee YH, et al. Routine chest CT for staging of gastric cancer. British Journal of Surgery. 106(9):1197-1203, 2019 08. |
Review/Other-Dx |
1669 patients |
To assess the clinical value of routine chest CT in the staging of gastric cancer. |
Some 1669 patients were included, of whom 478 (28·6 per cent) had metastatic disease at clinical presentation. The majority of metastases were to the peritoneum (75·7 per cent of patients) or liver (30·5 per cent), and only 27 patients (5·6 per cent) had pulmonary metastases at presentation, none of which were isolated to the lung. Of these 27 patients, 11 had primary lesions located at the cardia/fundus. In 19 patients the lung metastases were also detected on the staging chest X-ray. After surgery there were 196 cancer recurrences. Some 15 patients (7·6 per cent) had lung metastasis and this was not the only site of metastases in any patient. The prevalence of lung metastasis at presentation of the disease and after surgery was 1·6 and 1·5 per cent respectively. |
4 |
| 45. Nostedt J, Gibson-Brokop L, Ghosh S, Seidler M, McCall M, Schiller D. Evaluating the utility of computed tomography of the chest for gastric cancer staging. Canadian Journal of Surgery. 63(1):E57-E61, 2020 02 07. |
Review/Other-Dx |
462 |
The primary aim of the study was to determine the incidence of pulmonary metastases at the time of diagnosis in this population. A secondary aim was to identify potential predictors of pulmonary metastases. |
Four hundred and sixty-two patients (311 men, 151 women) were included in the analysis. Pulmonary metastases were identified in 25 patients (5.4%) overall and in 11 of 299 patients (3.7%) whose primary cancer was not in the cardia. On univariate analysis the presence of liver metastases (odds ratio [OR] 7.72, 95% confidence interval [CI] 3.24–18.37, p < 0.001) and abdominal lymphadenopathy (OR 3.30, 95% CI 1.29–8.48, p = 0.01) was associated with an increased risk of pulmonary metastases. Liver metastases retained statistical significance on multivariate analysis (OR 6.17, 95% CI 2.53–15.03, p < 0.001). |
4 |
| 46. Bozkurt M, Doganay S, Kantarci M, et al. Comparison of peritoneal tumor imaging using conventional MR imaging and diffusion-weighted MR imaging with different b values. Eur J Radiol 2011;80:224-8. |
Observational-Dx |
19 patients |
The aim of this study was to evaluate the utility of DW MRI with two different b values in identifying peritoneal tumors in oncology patients. |
One-hundred and twenty-five peritoneal metastasis sites were confirmed by surgical and histopathological findings. Conventional MRI alone identified 72 peritoneal metastases (sensitivity, 0.58; specificity, 0.87; accuracy, 0.67). Combined DWI with a b value of 400 s/mm2 and conventional MRI revealed 106 peritoneal metastases (sensitivity, 0.85; specificity, 0.88; accuracy, 0.85). Finally, combined DWI with a b value of 800 s/mm2 and conventional MRI revealed 103 peritoneal metastases (sensitivity, 0.83; specificity, 0.94; accuracy, 0.86). |
3 |
| 47. Borggreve AS, Goense L, Brenkman HJF, et al. Imaging strategies in the management of gastric cancer: current role and future potential of MRI. [Review]. British Journal of Radiology. 92(1097):20181044, 2019 May. |
Review/Other-Dx |
n/a |
There is limited evidence on the performance of MRI for M-staging of gastric cancer specifically, but MRI is widely used for diagnosing liver metastases and shows potential for diagnosing peritoneal seeding. Recent pilot studies showed that treatment response assessment as well as detection of lymph node metastases and systemic disease might benefit from functional MRI (e.g. diffusion weighted imaging and dynamic contrast enhancement). Regarding treatment guidance, additional value of MRI might be expected from its role in better defining clinical target volumes and setup verification with MR-guided radiation treatment. |
n/a |
4 |
| 48. Debiec K, Wydmanski J, d'Amico A, et al. The application of 18F-FDG-PET/CT in gastric cancerstaging and factors affecting its sensitivity. Hellenic Journal of Nuclear Medicine. 24(1):66-74, 2021 Jan-Apr. |
Observational-Dx |
111 |
To evaluate the accuracy offluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), to correctly determine initial tumor stage in treatment-naive gastric cancer patients and to analyze the factors influencing the risk of false negative results |
The sensitivity, specificity, PPV and NPV of PET/CT to visualize distant metastases were 76.4%; 86.7%; 83% and 81.2%, respectively. In 13 (11.7%) patients the PET/CT exam was able to identify metastatic sites not recognized in radiographic staging, significantly altering the initially planned management. Of 64 PET/CT studies negative for distant metastases, 12 (18.75%) were clinically confirmed to be false negative. The risk of acquiring a FN result for primary tumor was 10.8% (12/111) and the overall risk of any FN readout for either primary and metastatic sites was 18.9% (21/111). The factors that contributed to increased probability of a FN result for primary tumor detection were early primary tumor stage T1-T2 (+16.2%; ?2=5.0, P=0.025), female sex (+10.1%; ?2=5.71, P=0.017) and neutrophil count below 4.2k/µL (9.7%; ?2=6.1, P=0.014). Patients with non-intestinal Lauren histologic type (+18.7%; ?2=8.9, P=0.003) or signet-ring/mucinous carcinoma (+9.6%; ?2=7.7, P=0.005) had increased probability of PET/CT being unable to identify their distant metastases. Women and patients with low neutrophil count featured borderline insignificantly increased percentage of non-intestinal tumor histology (P=0.07 and P=0.057, respectively). |
3 |
| 49. Altini C, Niccoli Asabella A, Di Palo A, et al. 18F-FDG PET/CT role in staging of gastric carcinomas: comparison with conventional contrast enhancement computed tomography. Medicine. 94(20):e864, 2015 May. |
Observational-Dx |
45 |
The purpose of the report was to evaluate the role of fluorine-18 fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in staging gastric cancer comparing it with contrast enhancement computed tomography (CECT). |
CECT resulted positive for gastric localizations in 38/45 pts (84.4%) and negative in 7/45 pts (15.6%). 18F-FDG PET/CT resulted positive for gastric localization in 32/45 pts (71.1%) and negative in 13/45 pts (28.9%). |
2 |
| 50. Park K, Jang G, Baek S, Song H. Usefulness of combined PET/CT to assess regional lymph node involvement in gastric cancer. Tumori. 100(2):201-6, 2014 Mar-Apr. |
Observational-Dx |
74 patients |
To evaluate the value of positron emission tomography/computed tomography (PET/CT) for preoperative staging of gastric cancer and to compare the diagnostic performance of PET/CT with that of contrast-enhanced computed tomography (CECT). |
Advanced gastric cancer was present in 65% of patients (n = 48), and the remaining patients had early gastric cancer (n = 26). Sixteen patients (22%) showed signet-ring-cell histology. For the detection of the primary tumor, the sensitivity of PET/CT was significantly higher than that of CECT (67% vs 55%, respectively; P = 0.049). For the evaluation of regional lymph node metastasis, the sensitivity, specificity, and accuracy of PET/CT and CECT were 34% and 51% (P = 0.065), 88% and 79% (P = 0.687), and 58% and 64% (P = 0.332), respectively. Neither PET/CT nor CECT detected regional lymph node metastases in early gastric cancer patients. Signet-ring-cell histology showed trends of non-FDG-avid lymph node metastases (odds ratio = 0.15, 95% confidence interval 0.17-1.37, P = 0.093). |
3 |
| 51. Lehmann K, Eshmuminov D, Bauerfeind P, et al. 18FDG-PET-CT improves specificity of preoperative lymph-node staging in patients with intestinal but not diffuse-type esophagogastric adenocarcinoma. European Journal of Surgical Oncology. 43(1):196-202, 2017 Jan.Eur J Surg Oncol. 43(1):196-202, 2017 Jan. |
Observational-Dx |
221 patients |
To assess the accuracy of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT) for lymph-node staging in patients with adenocarcinoma of the esophagogastric junction (AEG) or gastric cancer (GC), with or without neoadjuvant treatment. |
PET-CT showed a high specificity (91%) and positive predictive value (89%) for the preoperative detection of lymph-node metastases. In comparison, EUS was more sensitive (73% versus 50%, P < 0.01) but less specific (60%, P < 0.01). In patients with intestinal/mixed-type tumors, PET-CT improved the detection of extra-regional lymph-node metastases (P = 0.01) and distant metastases (P = 0.01) compared to CT alone. In contrast, lymph-node assessment by PET/CT after neoadjuvant treatment (32%, P < 0.01) and in diffuse-type cancers (24%, P < 0.01) is futile because of low sensitivities. |
3 |
| 52. Park JS, Lee N, Beom SH, et al. The prognostic value of volume-based parameters using 18F-FDG PET/CT in gastric cancer according to HER2 status. Gastric Cancer. 21(2):213-224, 2018 Mar. |
Observational-Dx |
124 |
We aimed to find the clinical value of metastatic tumor burden evaluated with F18-FDG PET/CT in gastric cancer patients, considering the human epidermal growth factor receptor 2 (HER2) status. |
SUVmax was higher in HER2-positive gastric cancers (median 12.1, range 3.4-34.6) compared to HER-2 negative (7.4, 1.6-39.1, P < 0.001). Among all patients, WB TLG > 600, which is indicative of a high metastatic tumor burden, showed worse progression-free survival (PFS) [hazard ratio (HR), 2.003; 95% CI, 1.300-3.086; P = 0.002] and overall survival (OS) (HR, 3.001; 95% CI, 1.950-4.618; P < 0.001) than did WB TLG = 600. Among HER2-positive gastric cancer patients treated with trastuzumab, higher metabolic tumor burden predicted worse OS, but not PFS |
2 |
| 53. Mirshahvalad SA, Seyedinia SS, Huemer F, et al. Prognostic value of [18F]FDG PET/CT on treatment response and progression-free survival of gastroesophageal cancer patients undergoing perioperative FLOT chemotherapy. European Journal of Radiology. 163:110843, 2023 Jun. |
Review/Other-Dx |
31 patients |
To evaluate the prognostic role of [18F]FDG PET/CT metabolic parameters in gastric cancer (GC) and gastroesophageal adenocarcinoma (GEJAC) patients receiving neoadjuvant chemotherapy. |
Thirty-one patients (mean age = 62 ± 8), including 21 GC and 10 GEJAC patients, were evaluated. 20/31(65%) patients were histopathology responders to neoadjuvant chemotherapy, including twelve complete and eight partial responders. During the median follow-up of 42.0 months, nine patients experienced recurrence. The median PFS was 60(95% CI:32.9-87.1) months. Pre-neoadjuvant chemotherapy SULpeak was significantly correlated with pathological response to treatment (p-value = 0.03;odds ratio = 16.75). In survival analysis, SUVmax (p-value = 0.01;hazard ratio[HR] = 1.55), SUVmean (p-value = 0.04;HR = 2.73), SULpeak (p-value < 0.001;HR = 1.91) and SULmean (p-value = 0.04;HR = 4.22) in the post-neoadjuvant chemotherapy pre-operative [18F]FDG PET/CT showed significant correlation with PFS. Additionally, aspects of staging were significantly correlated with PFS (p-value = 0.01;HR = 2.21). |
4 |
| 54. Findlay JM, Antonowicz S, Segaran A, et al. Routinely staging gastric cancer with 18F-FDG PET-CT detects additional metastases and predicts early recurrence and death after surgery. European Radiology. 29(5):2490-2498, 2019 May. |
Review/Other-Dx |
279 patients |
To determine the contemporary utility of routine 18F-FDG PET-CT in gastric cancer. |
The primary tumor was FDG-avid in 225/279 patients (80.6%). Seventy-two (25.8%) had FDG-avid nodes (resectable by D2 lymphadenectomy). This was not influenced by the Lauren classification. Unsuspected metastases were identified in 20 patients (7.2%). In 13 (4.7%), these would not have been otherwise identified. Decision theory and economic modeling supported routine PET-CT. Patients with FDG-avid nodes were more likely to have incurable disease (51.4% versus 15.5%; p < 0.001), and a worse prognosis if not: multivariate hazard ratio 2.19 (1.23-3.91; p = 0.008). Prognosis worsened with mN stage. |
4 |
| 55. Song BI, Kim HW, Won KS, Ryu SW, Sohn SS, Kang YN. Preoperative Standardized Uptake Value of Metastatic Lymph Nodes Measured by 18F-FDG PET/CT Improves the Prediction of Prognosis in Gastric Cancer. Medicine. 94(26):e1037, 2015 Jul. |
Review/Other-Dx |
151 |
To assess whether preoperative maximum standardized uptake value (SUVmax) of metastatic lymph nodes (LNs) measured by F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (F-FDG PET/CT) could improve the prediction of prognosis in gastric cancer. |
One hundred fifty-one patients with gastric cancer and pathologically confirmed LN involvement who had undergone preoperative F-FDG PET/CT prior to curative surgical resection were retrospectively enrolled. To obtain nodal SUVmax, a transaxial image representing the highest F-FDG uptake was carefully selected, and a region of interest was manually drawn on the highest F-FDG accumulating LN. Conventional prognostic parameters and PET findings (primary tumor and nodal SUVmax) were analyzed for prediction of recurrence-free survival (RFS) and overall survival (OS). Furthermore, prognostic accuracy of survival models was assessed using c-statistics. Of the 151 patients, 38 (25%) experienced recurrence and 34 (23%) died during follow-up (median follow-up, 48 months; range, 5-74 months). Twenty-seven patients (18%) showed positive F-FDG nodal uptake (range, 2.0-22.6). In these 27 patients, a receiver-operating characteristic curve demonstrated a nodal SUVmax of 2.8 to be the optimal cutoff for predicting RFS and OS. The univariate and multivariate analyses showed that nodal SUVmax (hazard ratio [HR] = 2.71, P < 0.0001), pathologic N (pN) stage (HR = 2.58, P = 0.0058), and pathologic T (pT) stage (HR = 1.77, P = 0.0191) were independent prognostic factors for RFS. Also, nodal SUVmax (HR = 2.80, P < 0.0001) and pN stage (HR = 2.28, P = 0.0222) were independent prognostic factors for OS. A predictive survival model incorporating conventional risk factors (pT/pN stage) gave a c-statistic of 0.833 for RFS and 0.827 for OS, whereas a model combination of nodal SUVmax with pT/pN stage gave a c-statistic of 0.871 for RFS (P = 0.0355) and 0.877 for OS (P = 0.0313). |
4 |
| 56. Yamada K, Urakawa N, Kanaji S, et al. Preoperative prediction of the pathological stage of advanced gastric cancer by 18F-fluoro-2-deoxyglucose positron emission tomography. Scientific Reports. 12(1):11370, 2022 07 05. |
Observational-Dx |
113 |
The study aimed to evaluate the usefulness of FDG-PET/CT in preoperative diagnosis of advanced gastric cancer. |
The median T-SUVmax and N-SUVmax were 5.08 (range, 0.78–34.1) and 1.57 (range, 0.74–14.3), respectively. T-SUVmax (median, range) was not significantly different between each tumor location (Upper: 5.00, 2.00–25.23; Middle: 3.62, 0.78–21.55; Lower: 6.90, 1.43–34.05, P?=?0.14). There was also no significant difference between type1.2 (4.98, 0.78–25.23) and type3.4 (4.50, 2.00–34.05) in macroscopic type (P?=?0.65). In pathological depth of tumor, T-SUVmax (median, range) was significantly higher in T3, 4 (7.33, 2.00–34.05) than T1, 2 (3.13, 0.78–13.02) (P?<?0.005). We evaluated the relationship between histological type and SUVmax. The median T-SUVmax was 6.34 (1.18–34.1) for the differentiated type and 3.57 (0.78–21.6) for the undifferentiated type. The median N-SUVmax was 1.52 (0.74–12.3) for the differentiated type and 1.67 (0.89–14.3) for the undifferentiated type. The T-SUVmax were higher in the differentiated type than in the undifferentiated type (P?=?0.02), but there was no significant difference in the N-SUVmax (P?=?0.21). The AUCs of the T-SUVmax values to predict pT3/4 determined by ROC curve analysis were 0.86 (95% CI, 0.76–0.95) for the differentiated type and 0.80 (0.69–0.92) for the undifferentiated type (Fig. 1a,b). The AUCs of the T-SUVmax and N-SUVmax for predicting pathological lymph-node metastasis were 0.66 (0.56–0.76) and 0.76 (0.67–0.85), respectively (Fig. 1c). The cutoff values of T-SUVmax for pT3/4 were 8.28 for the differentiated type and 4.32 for the undifferentiated type, and the cutoff values of T-SUVmax and N-SUVmax for pathological lymph-node metastasis were 4.32 and 1.82, respectively. |
2 |
| 57. Wang J, Yu X, Shi A, et al. Predictive value of 18F-FDG PET/CT multi-metabolic parameters and tumor metabolic heterogeneity in the prognosis of gastric cancer. Journal of Cancer Research & Clinical Oncology. 149(16):14535-14547, 2023 Nov. |
Observational-Dx |
71 |
We aimed to investigate the predictive value of pre-treatment 18F-FDG PET/CT multi-metabolic parameters and tumor metabolic heterogeneity for gastric cancer prognosis. |
A total of 71 patients with gastric cancer, including 57 (80.3%) males and 14 (19.7%) females, had a mean age of 61 ± 10 years; disease progression occurred in 27 (38.0%) patients and death occurred in 24 (33.8%) patients. Multivariate Cox regression analysis showed that HI-1 alone was a common independent risk factor for PFS (HR: 1.183; 95% CI: 1.010-1.387, P < 0.05) and OS (HR: 1.214; 95% CI: 1.016-1.450, P < 0.05) in patients with gastric cancer. A nomogram created based on the results of Cox regression analysis increased the net clinical benefit for patients. Considering disease progression as a positive event, patients were divided into low-, intermediate-, and high-risk groups, and Kaplan-Meier survival analysis showed that there were significant differences in PFS among the three groups. When death was considered a positive event and patients were included in the low- and high-risk groups, there were significant differences in OS between the two groups. |
2 |
| 58. Bosch KD, Chicklore S, Cook GJ, et al. Staging FDG PET-CT changes management in patients with gastric adenocarcinoma who are eligible for radical treatment. European Journal of Nuclear Medicine & Molecular Imaging. 47(4):759-767, 2020 04. |
Observational-Dx |
330 |
18-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) is valuable in the management of patients with oesophageal cancer, but a role in gastric cancer staging is debated. Our aim was to review the role of FDG PET-CT in a large gastric cancer cohort in a tertiary UK centre. |
Of the 105 patients (74 M, median age 73 years) 86% of primary tumours were metabolically active (uptake greater than normal stomach) on FDG PET-CT [41/44 (93%) of the intestinal histological subtype (SUVmax 14.1 ± 1.3) compared to 36/46 (78%) of non-intestinal types (SUVmax 9.0 ± 0.9), p = 0.005]. FDG PET-CT upstaged nodal or metastastic staging of 20 patients (19%; 13 intestinal, 6 non-intestinal, 1 not reported), with 17 showing distant metastases not evident on other imaging. On histological analysis, available in 30 patients, FDG PET-CT showed low sensitivity (40%) but higher specificity (73%) for nodal involvement. |
3 |
| 59. Gertsen EC, Brenkman HJF, van Hillegersberg R, et al. 18F-Fludeoxyglucose-Positron Emission Tomography/Computed Tomography and Laparoscopy for Staging of Locally Advanced Gastric Cancer: A Multicenter Prospective Dutch Cohort Study (PLASTIC). JAMA Surgery. 156(12):e215340, 2021 12 01. |
Observational-Dx |
394 |
To evaluate the value of 18F-fludeoxyglucose-positron emission tomography with computed tomography (FDG-PET/CT) and staging laparoscopy (SL) in addition to initial staging by means of gastroscopy and CT in patients with locally advanced gastric cancer. |
Of the 394 patients included, 256 (65%) were men and mean (SD) age was 67.6 (10.7) years. A total of 382 patients underwent FDG-PET/CT and 357 underwent SL. Treatment intent changed from curative to palliative in 65 patients (16%) based on the additional FDG-PET/CT and SL findings. FDG-PET/CT detected distant metastases in 12 patients (3%), and SL detected peritoneal or locally nonresectable disease in 73 patients (19%), with an overlap of 7 patients (2%). FDG-PET/CT had a sensitivity of 33% (95% CI, 17%-53%) and specificity of 97% (95% CI, 94%-99%) in detecting distant metastases. Secondary findings on FDG/PET were found in 83 of 382 patients (22%), which led to additional examinations in 65 of 394 patients (16%). Staging laparoscopy resulted in a complication requiring reintervention in 3 patients (0.8%) without postoperative mortality. The mean (SD) diagnostic delay was 19 (14) days |
3 |
| 60. Ma DW, Kim JH, Jeon TJ, et al. 18F-fluorodeoxyglucose positron emission tomography-computed tomography for the evaluation of bone metastasis in patients with gastric cancer. Digestive & Liver Disease. 45(9):769-75, 2013 Sep. |
Observational-Dx |
1485 patients |
We compared the usefulness of positron emission tomography–computed tomography and scanning in detecting bone metastasis in gastric cancer. |
The sensitivity, specificity, and accuracy were 93.5%, 25.0%, and 80.6%, respectively, for positron emission tomography and 93.5%, 37.5%, and 82.9%, respectively, for scanning. 87.7% of patients with bone metastasis showed positive findings on two modalities. 15.0% of solitary bone metastases were positive on positron emission tomography only. Positron emission tomography was superior to scanning for the detection of synchronous bone metastasis, but the two modalities were similar for the detection of metachronous bone metastasis. The concordance rate of response assessment after treatment between two modalities was moderate. |
3 |
| 61. Chon HJ, Kim C, Cho A, et al. The clinical implications of FDG-PET/CT differ according to histology in advanced gastric cancer. Gastric Cancer. 22(1):113-122, 2019 01. |
Observational-Dx |
900 |
To evaluate the prognostic impact of SUVmax in preoperative 18F-FDG PET/CT of AGC according to histologic subtype, with a focus on the differences between tubular adenocarcinoma and signet ring cell (SRC) carcinoma. |
In multivariate analysis, high SUVmax in preoperative 18F-FDG PET/CT of AGC was negatively correlated with disease-free survival (DFS) and overall survival (OS) in patients with diffuse type (DFS: HR 2.17, P < 0.001; OS: HR 2.47, P < 0.001) or SRC histology (DFS: HR 2.26, P = 0.005; OS: HR 2.61, P = 0.003). This negative prognostic impact was not observed in patients with intestinal type or well or moderately differentiated histology. These findings have been consistently confirmed in a validation set. The p-spline curves also showed a gradual increase in log HR as SUVmax rises only for SRC histology and for diffuse-type AGC. Finally, a novel predictive model for recurrence of AGC with diffuse type or SRC histology was generated and validated based on the preoperative SUVmax. |
3 |
| 62. Chung HW, Kim JH, Sung IK, et al. FDG PET/CT to predict the curability of endoscopic resection for early gastric cancer. Journal of Cancer Research & Clinical Oncology. 145(3):759-764, 2019 Mar. |
Observational-Dx |
199 patients |
Evaluation of the value of fluorine-18 fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) as a complementary imaging modality to endoscopy to predict the curability of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). |
The detection rate of EGC by FDG PET/CT was 37.1% (78 discrete radioactivity in 210 EGCs). However, for the detection of EGC that is not curable by ESD, the sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve with 95% confidence intervals were 79% (67–87%), 91% (85–95%), 81% (71–88%), 89% (84–93%), and 0.85 (0.79–0.89), respectively. |
3 |
| 63. Gai Q-, Li X-, Li N, Li L, Meng Z, Chen A-. Clinical significance of multi-slice spiral CT, MRI combined with gastric contrast-enhanced ultrasonography in the diagnosis of T staging of gastric cancer. Clinical & Translational Oncology: Official Publication of the Federation of Spanish Oncology Societes & of the National Cancer Institute of Mexico. 23(10):2036-2045, 2021 Oct. |
Review/Other-Dx |
109 |
To explore the application value of multi-slice spiral CT (MSCT), magnetic resonance imaging (MRI) combined with gastric contrast-enhanced ultrasonography in the diagnosis of T staging of gastric cancer. |
The sensitivity of MSCT in the diagnosis of T staging of gastric cancer was 60.00%, 67.74%, 72.22%, 76.47%, the specificity was 95.24%, 88.46%, 86.30%, 94.56% and the diagnostic coincidence rate was 87.16%, 82.57%, 81.65%, 91.74%; the sensitivity of MRI in the diagnosis of T staging of gastric cancer was 68.00%, 70.97%, 77.78%, 76.47%, the specificity was 92.86%, 88.46%, 91.78%, 95.65%, and the diagnostic coincidence rate was 87.16%, 83.49%, 87.16%, 92.66%; the sensitivity of gastric contrast-enhanced ultrasonography in the diagnosis of T staging of gastric cancer was 80.00%, 83.87%, 86.11%, 82.35%, the specificity was 97.62%, 92.31%, 91.78%, 97.83%, and the diagnostic coincidence rate was 93.58%, 89.91%, 89.91%, 95.41%; the sensitivity of combined MSCT, MRI and gastric contrast-enhanced ultrasonography in the diagnosis of T staging of gastric cancer was 88.00%, 93.55%, 97.22%, 94.12%; the specificity was 100%, 97.44%, 95.89%, 98.91%; and the diagnostic coincidence rate was 97.25%, 96.33%, 96.33%, 98.17%, respectively. |
4 |
| 64. Choi JI, Joo I, Lee JM. State-of-the-art preoperative staging of gastric cancer by MDCT and magnetic resonance imaging. [Review]. World Journal of Gastroenterology. 20(16):4546-57, 2014 Apr 28. |
Review/Other-Dx |
N/A |
Accurate staging for gastric cancer has become more critical due to the recent introduction of less invasive treatment options, such as endoscopic mucosal resection or laparoscopic surgery. |
No results stated in abstract. |
4 |
| 65. Li HH, Zhu H, Yue L, et al. Feasibility of free-breathing dynamic contrast-enhanced MRI of gastric cancer using a golden-angle radial stack-of-stars VIBE sequence: comparison with the conventional contrast-enhanced breath-hold 3D VIBE sequence. European Radiology. 28(5):1891-1899, 2018 May. |
Observational-Dx |
43 patients |
To investigate the feasibility and diagnostic value of free-breathing, radial, stack-of-stars three-dimensional (3D) gradient echo (GRE) sequence ("golden angle") on dynamic contrast-enhanced (DCE) MRI of gastric cancer. |
For uncooperative patients, 3D GRE scored higher qualitatively, and had higher SNRs (signal-to-noise ratios) and CNRs (contrast-to-noise ratios) than conventional VIBE quantitatively. Though 3D GRE images scored lower in qualitative parameters compared with conventional VIBE for cooperative patients, it provided images with fewer artefacts. DCE parameters differed significantly between normal gastric wall and lesions, with higher Ve (extracellular volume) and lower Kep (reflux constant) in gastric cancer. |
2 |
| 66. Qiao X, Li Z, Li L, et al. Preoperative T2-weighted MR imaging texture analysis of gastric cancer: prediction of TNM stages. Abdominal Radiology. 46(4):1487-1497, 2021 04. |
Observational-Dx |
80 patients |
To explore the capability of algorithms to build multivariate models integrating morphological and texture features derived from preoperative T2-weighted magnetic resonance (MR) images of gastric cancer (GC) to evaluate tumor- (T), node- (N), and metastasis- (M) stages. |
There were 8, 10, and 3 texture parameters that showed significant differences in GCs at different overall (I-II vs. III-IV), T (1-2 vs. 3-4), and N (- vs. +) stages (all p < 0.05), respectively. Mild thickening was more common in stages I-II, T1-2, and N- GCs (all p < 0.05). An irregular outer contour was more commonly observed in stages III-IV (p = 0.001) and T3-4 (p = 0.001) GCs. T3-4 and N+ GCs tended to be thickening type lesions (p = 0.005 and 0.032, respectively). The multivariate models using the naive bayes algorithm showed the highest diagnostic efficacy in predicting T and N stages (area under the ROC curves [AUC] = 0.900 and 0.863, respectively), and the model based on regression analysis had the best predictive performance in overall staging (AUC = 0.839). |
3 |
| 67. Caivano R, Rabasco P, Lotumolo A, et al. Gastric cancer: The role of diffusion weighted imaging in the preoperative staging. Cancer Investigation. 32(5):184-90, 2014 Jun. |
Observational-Dx |
31 patients |
To evaluate the role of diffusion-weighted-imaging (DWI) in the diagnosis and staging of gastric carcinoma. |
The T factor accuracy of conventional MRI and DWI was 73% and 80% respectively; while the N staging accuracy of conventional MRI and DWI was 80% and 93%, respectively. |
2 |
| 68. Zhang Y, Yu J. The role of MRI in the diagnosis and treatment of gastric cancer. [Review]. Diagnostic & Interventional Radiology. 26(3):176-182, 2020 May. |
Review/Other-Tx |
0 |
This article aims to review the current status of the application and research progress of MRI in patients with gastric cancer. |
No results stated in abstract |
4 |
| 69. Giganti F, Orsenigo E, Esposito A, et al. Prognostic Role of Diffusion-weighted MR Imaging for Resectable Gastric Cancer. Radiology. 276(2):444-52, 2015 Aug. |
Observational-Dx |
99 patients with biopsy-proved cancer |
To prospectively investigate the role of apparent diffusion coefficient (ADC) calculated from diffusion-weighted magnetic resonance (MR) imaging as a potential prognostic biomarker in the evaluation of the aggressiveness of gastric cancer. |
At a total median follow-up period of 21 months, 31 patients had died. The median follow-up was 25 months for the surgery-only group (19 of 31 events [61%]) and 28 months for the chemotherapy group (12 of 31 events [39%]). In the multivariate analysis, ADC values of 1.5 × 10(-3) mm(2)/sec or lower were associated with a negative prognosis, both in the total population (log-relative risk, 1.73; standard error, 0.56; P = .002) and in the surgery-only (log-relative risk, 1.97; standard error, 0.66; P = .003) and chemotherapy (log-relative risk, 2.93; standard error, 1.41; P = .03) groups, along with other significant prognostic factors (in particular, pathologic T and N stages). |
2 |
| 70. Liu S, Wang H, Guan W, et al. Preoperative apparent diffusion coefficient value of gastric cancer by diffusion-weighted imaging: Correlations with postoperative TNM staging. Journal of Magnetic Resonance Imaging. 42(3):837-43, 2015 Sep. |
Observational-Dx |
70 |
To determine if the apparent diffusion coefficient (ADC) values of gastric cancers on the preoperative diffusion weighted imaging (DWI) correlate with the postoperative TNMs of the lesions. |
Both mean and minimum ADC values of the gastric cancers correlated with the postoperative T staging (r = -0.464, -0.476; both P < 0.001), N staging (r = -0.402, -0.397; P = 0.001, 0.002) and TNM staging (r = -0.446, -0.437; both P < 0.001). The areas under the receiver operating characteristic (ROC) curves for the differentiating lymph node metastasis were 0.788 for the mean ADC values (P = 0.001) and 0.778 for the minimum ADC values (P = 0.001). |
1 |
| 71. Kim IY, Kim SW, Shin HC, et al. MRI of gastric carcinoma: results of T and N-staging in an in vitro study. World J Gastroenterol 2009;15:3992-8. |
Observational-Dx |
20 patients |
To determine the accuracy of 1.5-T magnetic resonance imaging (MRI) in the evaluation of gastric wall invasion and perigastric lymph node metastasis in gastric adenocarcinoma. |
A T1-weighted image demonstrated three layers in the normal gastric wall. All of the gastric tumors were well demonstrated by lesions and location. In a MRI findings of gastric wall invasion, there was 1 case of T1, 7 of T2, 11 of T3. Pathologic results of resected specimens included 3 cases of pT1, 4 of pT2, and 12 of pT3. The accuracy of T staging with MRI was 74% (14 of 19). MRI findings of lymph node metastasis included 6 cases of N0, 13 cases of N1. The accuracy of the N staging with MRI was 47% (9 of 19). |
2 |
| 72. Joo I, Lee JM, Kim JH, Shin CI, Han JK, Choi BI. Prospective comparison of 3T MRI with diffusion-weighted imaging and MDCT for the preoperative TNM staging of gastric cancer. Journal of Magnetic Resonance Imaging. 41(3):814-21, 2015 Mar. |
Observational-Dx |
49 patients |
To compare the diagnostic performance of 3T magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) and multidetector-row computed tomography (MDCT) for the preoperative tumor-node-metastasis (TNM) staging of gastric cancer. |
Diagnostic accuracies of MRI with DWI, MRI without DWI, and MDCT did not show a significant difference (=T2 vs. =T3: 85.1%, 78.7%, and 80.9%; =T3 vs. T4: 76.6%, 74.5%, and 72.3%; N-negative vs. N-positive: 76.6%, 66.0%, and 63.8%; M0 vs. M1: all 95.9%, respectively) (P?>?0.05). For N staging, MRI with DWI demonstrated higher sensitivity but lower specificity (86.7% and 58.8%, respectively) than MRI without DWI (50.0% and 94.1%) or MDCT (43.3% and 100%) (P?<?0.05). |
1 |
| 73. Soydan L, Demir AA, Torun M, Cikrikcioglu MA. Use of Diffusion-Weighted Magnetic Resonance Imaging and Apparent Diffusion Coefficient in Gastric Cancer Staging. Current Medical Imaging. 16(10):1278-1289, 2020. |
Observational-Dx |
46 patients |
To investigate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) and its quantitative parameter, apparent diffusion coefficient (ADC) in staging of gastric cancer. |
Sensitivity, specificity, and accuracy of DW-MRI in T-staging were 92.1%, 75%, 89.1% for =T2 vs. =T3; and 75%, 88.5%, 82.6% for =T3 vs. T4. However, sensitivity, specificity, and accuracy of DW-MRI in N-staging were 89.3%, 88.9%, 89.1% for =N1 vs. =N2; and 73.7%, 96.3%, 86.9% for =N2 vs. N3, respectively. Relative preoperative ADC values correlated with pT staging (r=-0.397, p=0.006). There was also a statistically significant difference of relative ADC values between =T3 and T4 stages, and a cut-off of 0.64 s/mm2 could differentiate these stages with an odds ratio of 7.714 (95% confidence interval, 1.479-40.243). The area under the receiver operating characteristic curve for differentiating =T3 and T4 stages was 0.725. |
2 |
| 74. Liu S, Zhang Y, Xia J, et al. Predicting the nodal status in gastric cancers: The role of apparent diffusion coefficient histogram characteristic analysis. Magnetic Resonance Imaging. 42:144-151, 2017 10. |
Observational-Dx |
87 patients with gastric cancers |
To explore the application of histogram analysis in preoperative T and N staging of gastric cancers, with a focus on characteristic parameters of apparent diffusion coefficient (ADC) maps. |
Four parameters, including skew, kurtosis, s-sDav and sample number, showed significant differences among gastric cancers at different T and N stages. Most parameters correlated with T and N stages significantly and worked in differentiating gastric cancers at different T or N stages. Especially skew yielded a sensitivity of 0.758, a specificity of 0.810, and an area under the curve (AUC) of 0.802 for differentiating gastric cancers with and without lymph node metastasis (P<0.001). All the parameters, except AUClow, showed good or excellent inter-observer agreement with intra-class correlation coefficients ranging from 0.710 to 0.991. |
3 |
| 75. Maegerlein C, Fingerle AA, Souvatzoglou M, Rummeny EJ, Holzapfel K. Detection of liver metastases in patients with adenocarcinomas of the gastrointestinal tract: comparison of (18)F-FDG PET/CT and MR imaging. Abdom Imaging 2015;40:1213-22. |
Observational-Dx |
49 patients |
To compare the diagnostic performance of (18)F-FDG PET/CT and MR imaging (MRI) in the detection of liver metastases in patients with adenocarcinomas of the gastrointestinal tract. MR images were with and without contrast. |
A total of 151 metastases were confirmed. For lesion detection, MRI was significantly superior to (18)F-FDG PET/CT. Sensitivity of MRI in detecting metastases was 86.8% for Reader 1 (R1) and 87.4% for Reader 2 (R2), of PET/CT 66.2% for R1 and 68.2% for R2. Regarding only metastases with diameters of 10 mm or less, sensitivities of MRI were 66.7% for R1 and 75.0% for R2, and were significantly higher than those of PET/CT (17.9% for R1 and 20.5% for R2). ROC analysis showed superiority for lesion classification of MRI as compared to (18)F-FDG PET/CT. |
3 |
| 76. Low RN, Sebrechts CP, Barone RM, Muller W. Diffusion-weighted MRI of peritoneal tumors: comparison with conventional MRI and surgical and histopathologic findings--a feasibility study. AJR Am J Roentgenol 2009;193:461-70. |
Observational-Dx |
34 consecutive oncology patients; 2 independent observers |
To evaluate the utility of single-shot spin-echo echo-planar DWI using a b value of 400-500 s/mm(2) for depicting peritoneal tumors. |
255 sites of peritoneal tumor were proven by surgical and histopathologic findings. The combination of DWI and conventional MRI was most sensitive and accurate for peritoneal tumors, depicting 230 and 214 tumor sites for the two observers (sensitivity, 0.90, 0.84; and accuracy, 0.91, 0.88) compared with DWI alone, which depicted 182 and 182 tumor sites with sensitivity (0.71, 0.71; and accuracy, 0.81, 0.81), and conventional MRI alone, which depicted 185 and 132 tumor sites (sensitivity, 0.73, 0.52; and accuracy, 0.81, 0.72). Peritoneal tumor showed restricted diffusion on DWI and ascites was of low signal intensity, increasing tumor conspicuity. Adding DWI to routine MRI improves the sensitivity and specificity for depicting peritoneal metastases. |
2 |
| 77. Liu S, He J, Guan W, et al. Preoperative T staging of gastric cancer: comparison of diffusion- and T2-weighted magnetic resonance imaging. Journal of Computer Assisted Tomography. 38(4):544-50, 2014 Jul-Aug. |
Observational-Dx |
45 patients that underwent MR imaging |
To assess the clinical feasibility of diffusion-weighted (DW) magnetic resonance (MR) imaging in preoperative T staging of gastric cancer prospectively. |
Diffusion-weighted and T2W images detected 44 and 42 of 45 histologically confirmed lesions, respectively. Furthermore, DW images detected 11 of 12 pT1 lesions compared to 9 of 12 lesions by T2W images. The staging accuracy of advanced gastric cancer (=pT2) in DW imaging is significantly higher than that in T2W imaging (87.9% and 69.7%, respectively; P < 0.05). |
2 |
| 78. Liu S, Guan W, Wang H, et al. Apparent diffusion coefficient value of gastric cancer by diffusion-weighted imaging: correlations with the histological differentiation and Lauren classification. European Journal of Radiology. 83(12):2122-2128, 2014 Dec. |
Review/Other-Dx |
69 patients with gastric cancer lesions |
To evaluate the correlations between histological differentiation and Lauren classification of gastric cancer and the apparent diffusion coefficient (ADC) value of diffusion weighted imaging (DWI). |
The mean and minimum ADC values of gastric cancers, as a whole and separately, were significantly lower than those of normal gastric walls (all p values <0.001). There were significant differences in the mean and minimum ADC values among gastric cancers with different histological types, degrees of differentiation and Lauren classifications (p<0.05). Mean and minimum ADC values correlated significantly (all p<0.001) with histological differentiation (r=0.564, 0.578) and Lauren classification (r=-0.493, -0.481). |
4 |
| 79. Li J, Yan LL, Zhang HK, et al. Application of intravoxel incoherent motion diffusion-weighted imaging for preoperative knowledge of lymphovascular invasion in gastric cancer: a prospective study. Abdominal Radiology. 48(7):2207-2218, 2023 07. |
Observational-Dx |
90 patients who received radical gastrostomy |
To investigate the potential of intravoxel incoherent motion diffusion-weighted imaging (IVIM) for preoperative prediction of lymphovascular invasion (LVI) in gastric cancer (GC). |
The ADC, D in LVI-positive group were lower, whereas tumor thickness and f parameter in LVI-positive group were higher than those in LVI-negative group, and they were statistically correlated with LVI (p < 0.05). D, f and tumor thickness were independent risk factors of LVI. The area under the curve of ADC, D, f, thickness, and the combined parameter (D + f + thickness) were 0.667, 0.754, 0.695, 0.792, and 0.876, respectively. The combined parameter demonstrated higher efficacy than any other parameters (p < 0.05). |
3 |
| 80. Zhang Y, Zhang J, Yang L, Huang S. A meta-analysis of the utility of transabdominal ultrasound for evaluation of gastric cancer. [Review]. Medicine. 100(32):e26928, 2021 Aug 13. |
Meta-analysis |
7 studies |
To meta-analyze the diagnostic accuracy and sensitivity of TAUS in discriminating between advanced and early GCs, as well as compare its utility with other imaging techniques. |
TAUS had distinct diagnostic efficacies for early and advanced GC patients. The accuracy and sensitivity were significantly higher in the advanced group. A high color Doppler vascularity index and a lesion larger than 1 cm were 2 features of advanced GC. Moreover, TAUS had a comparable (but slightly higher) accuracy than CT and EUS. |
Good |
| 81. He X, Sun J, Huang X, et al. Comparison of Oral Contrast-Enhanced Transabdominal Ultrasound Imaging With Transverse Contrast-Enhanced Computed Tomography in Preoperative Tumor Staging of Advanced Gastric Carcinoma. Journal of Ultrasound in Medicine. 36(12):2485-2493, 2017 Dec. |
Observational-Dx |
42 patients with advanced gastric cancer who underwent laparoscopy, radical surgery, or palliative surgery |
To assess the diagnostic performance of transabdominal oral contrast-enhanced ultrasound (US) imaging for preoperative tumor staging of advanced gastric carcinoma by comparing it with transverse contrast-enhanced computed tomography (CT). |
No significant difference was noted in the overall accuracy of transabdominal oral contrast-enhanced US (86% [36 of 42]) and transverse contrast-enhanced CT (83% [35 of 42] P > .999). For stage T2 to T4 gastric cancer, the accuracies of transabdominal oral contrast-enhanced US were 88%, 86%, and 98%, respectively, and those of transverse contrast-enhanced CT were 93%, 83%, and 90%. |
2 |
| 82. Urakawa S, Michiura T, Tokuyama S, et al. Preoperative diagnosis of tumor depth in gastric cancer using transabdominal ultrasonography compared to using endoscopy and computed tomography. Surgical Endoscopy. 37(5):3807-3813, 2023 05. |
Observational-Dx |
178 consecutive patients with GC evaluated by TUS, endoscopy, and contrast CT before gastrectomy |
To investigate the efficacy and limitations of transabdominal ultrasonography (TUS) for the assessment of tumor invasion. |
The overall accuracy of clinical T staging using TUS was 47.8% (pT1a: 5.8% (2/35); pT1b: 58.8% (20/35); pT2: 69.6% (16/23); pT3: 66.7% (22/33); pT4a: 46% (23/50); pT4b: 100% (2/2)). Using endoscopy, contrast CT, and TUS, the overall accuracy was 60.7%. The accuracy of TUS was associated with the tumor region (U region: 50% (14/28); M: 31.8% (14/44); L: 53.7% (57/106); P = 0.048), but not with the cross-sectional parts (P = 0.49). Multivariate analysis identified inaccurate TUS as independently correlating with tumor region (M vs. U/L, odds ratio (OR) = 3.11, 95% confidence interval (CI) 1.41-6.87; P = 0.005) and pT (pT1 vs. pT2-4, OR = 3.00, 95%CI 1.31-6.87; P = 0.009). |
3 |
| 83. Yu T, Wang X, Zhao Z, et al. Prediction of T stage in gastric carcinoma by enhanced CT and oral contrast-enhanced ultrasonography. World Journal of Surgical Oncology. 13:184, 2015 May 19. |
Observational-Dx |
40 patients with gastric carcinoma confirmed by endoscopy, operation, and pathology |
To explore the values of enhanced CT and oral contrast-enhanced ultrasonography on preoperative T stage in gastric carcinoma. |
In this study, there were 5 cases with T1 stage, 9 cases with T2 stage, 20 cases with T3 stage, and 6 cases with T4 stage by pathology; 5 cases with T1 stage, 7 cases with T2 stage, 22 cases with T3 stage, and 6 cases with T4 stage by enhanced CT imaging with an accuracy of 75.00%; 6 cases with T1 stage, 7 cases with T2 stage, 22 cases with T3 stage, and 5 cases with T4 stage by ultrasonography examination, with an accuracy of 77.50%; and 4 cases with T1 stage, 10 cases with T2 stage, 19 cases with T3 stage, and 7 cases with T4 stage by both enhanced CT imaging and ultrasonography examination, with an accuracy of 85.00%. The accuracy of T staging in gastric carcinoma by both enhanced CT and ultrasound was higher than that either by enhanced CT or by ultrasound, respectively (P < 0.05). The anastomosis degree of the gastric carcinoma between enhanced CT and ultrasonography was ? = 0.404. |
3 |
| 84. Mehmedovic A, Mesihovic R, Saray A, Vanis N. Gastric cancer staging: EUS and CT. Medicinski Arhiv. 68(1):34-6, 2014. |
Review/Other-Dx |
277 patients |
Gastric cancer staging using EUS and CT. |
Laparoscopic surgery has been shown to improve quality of life for both early and locally advanced gastric cancer. Endoscopic ultrasonography (EUS), which is considered to be the most precise method for locoregional staging, was commonly used for differentiating mucosal lesions from submucosal lesions. By contrast, computed tomography (CT) was used to detect the presence of distant metastasis. The difference in accuracy between the < or = 20-mm group and other groups was statistically significant for both EUS and MDCT (P = 0.026 and P = 0.044, respectively). |
4 |
| 85. Han C, Xu T, Zhang Q, Liu J, Ding Z, Hou X. The New American Joint Committee on Cancer T staging system for stomach: increased complexity without clear improvement in predictive accuracy for endoscopic ultrasound. BMC Gastroenterology. 21(1):255, 2021 Jun 11. |
Review/Other-Dx |
348 patients |
To evaluate the superiority of EUS by using the 6th edition American Joint Committee on Cancer (AJCC) staging system for stomach cancer compared to the new 7th/8th edition. |
The accuracy of EUS T staging was 72.4% for the 7th/8th edition and 78.4% for the 6th edition. T3 stage accuracy was significantly worse when the T3 group status was changed. The tumor location, echoendoscope type, and histological type were associated with inaccuracy. We further analyzed the EUS image features for each tumor T stage and found that an indistinctly visible muscularis propria (MP) or with obvious thickening was considered an indicator of lesions involved in the MP with a sensitivity of 81.3%; an MP completely disappeared and accompanied with a serosal layer intact may be a marker that the lesion invaded to the subserosa. We also found that irregularities in the outer edge of the gastric wall were markers of gastric serosal layer penetration with a positive predictive value of 92.2%. |
4 |
| 86. Liu S, Zhang M, Yang Y, et al. Establishment and validation of a risk score model based on EUS: assessment of lymph node metastasis in early gastric cancer. Gastrointest Endosc 2024;100:857-66. |
Review/Other-Dx |
N/A |
To evaluate the efficacy of EUS in identifying lymph node metastasis in early gastric cancer patients and developed a risk score model to aid in choosing the best treatment options. |
The overall accuracy of EUS in identifying lymph node metastasis was 85.3%, although its sensitivity (29.2%) and positive predictive value (38.7%) were relatively low. Patients were categorized based on preoperative risk factors for lymph node metastasis, including tumor size of =20 mm, lymph nodes of =10 mm, body mass index of =24 kg/m2, and lymph node metastasis on CT scans. A 7-point risk score model was developed to assess the likelihood of lymph node metastasis. The areas under the receiver operating characteristic curve for the development and validation sets were 0.842 and 0.837, respectively, with sensitivities of 64% and 79%, respectively. |
4 |
| 87. Gertsen EC, de Jongh C, Brenkman HJF, et al. The additive value of restaging-CT during neoadjuvant chemotherapy for gastric cancer. European Journal of Surgical Oncology. 46(7):1247-1253, 2020 07. |
Observational-Dx |
152 patients |
To evaluate the additive value of restaging-CT during NAC in guiding clinical decision making in gastric cancer. |
Between 2007 and 2015, CT-restaging was performed in 122 out of 152 included patients andtimed after 2 cycles (n ¼ 76) or after 3 cycles (n ¼ 46) of NAC. Restaging-CT revealed a metastasis in 1 out of 122 restaged patients (1%) after which surgical resection was omitted, whereas 4 patients (3%) withdistant interval metastases were not identified by restaging-CT and underwent a futile laparotomy. In 5out of 76 patients (7%) disease progression was detected while undergoing NAC, leading to omission ofthe 3rd cycle of chemotherapy. |
4 |
| 88. Lee DH, Kim SH, Lee SM, Han JK. Prediction of Treatment Outcome of Chemotherapy Using Perfusion Computed Tomography in Patients with Unresectable Advanced Gastric Cancer. Korean Journal of Radiology. 20(4):589-598, 2019 04. |
Observational-Dx |
21 patients with unresectable AGCs, who underwent both PCT and palliative chemotherapy |
To evaluate whether data acquired from perfusion computed tomography (PCT) parameters can aid in the prediction of treatment outcome after palliative chemotherapy in patients with unresectable advanced gastric cancer (AGC). |
After chemotherapy, six patients exhibited partial response and were allocated to the responder group while the remaining 15 patients were allocated to the non-responder group. Permeability surface (PS) value was shown to be significantly different between the responder and non-responder groups (51.0 mL/100 g/min vs. 23.4 mL/100 g/min, respectively; p = 0.002), whereas other PCT parameters did not demonstrate a significant difference. The area under the curve for prediction in responders was 0.911 (p = 0.004) for PS value, with a sensitivity of 100% (6/6) and specificity of 80% (12/15) at a cut-off value of 29.7 mL/100 g/min. One-year survival in nine patients with PS value > 29.7 mL/100 g/min was 66.7%, which was significantly higher than that in the 12 patients (33.3%) with PS value = 29.7 mL/100 g/min (p = 0.019). |
3 |
| 89. Yoshikawa T, Tanabe K, Nishikawa K, et al. Accuracy of CT staging of locally advanced gastric cancer after neoadjuvant chemotherapy: cohort evaluation within a randomized phase II study. Annals of Surgical Oncology. 21 Suppl 3:S385-9, 2014 Jun. |
Observational-Dx |
75 patients |
To evaluate the radiologic accuracy of restaging after neoadjuvant chemotherapy using CT. |
A total of 75 patients registered in the COMPASS study who underwent surgical resection were examined in this study. The radiologic T and pathologic T stages were not significantly correlated (p = 0.221). The radiologic accuracy and rates of underdiagnosis and overdiagnosis were 42.7, 10.7, and 46.7%, respectively. When patients were stratified according to the pathologic response of the primary tumor, the correlation was not significant in either the responders (n = 32, p = 0.410) or the nonresponders (n = 43, p = 0.742). The radiologic accuracy was 37.5% in the responders and 42.7% in the nonresponders. The radiologic N and pathologic N stages were significantly correlated (p = 0.000). The radiologic accuracy and rates of underdiagnosis and overdiagnosis were 44, 29.3, and 26.7%, respectively. When stratifying the patients with measurable lymph nodes according only to the radiologic response, the correlation was significant in the nonresponders (n = 23, p = 0.035) but not in the responders (n = 28, p = 0.634). The radiologic accuracy was 39.3% in the responders and 52.1% in the nonresponders. |
3 |
| 90. Ott K, Fink U, Becker K, et al. Prediction of response to preoperative chemotherapy in gastric carcinoma by metabolic imaging: results of a prospective trial. J Clin Oncol 2003;21:4604-10. |
Observational-Dx |
44 consecutive patients with locally advanced gastric carcinomas |
To evaluate the predictive value of therapy-induced reduction of tumor glucose use for subsequent response and patient survival in patients with gastric cancer treated by preoperative chemotherapy. |
Thirty-five (80%) of the 44 tumors were visualized with sufficient contrast for quantitative analysis (two of 19 intestinal and seven of 25 nonintestinal tumors showed only low FDG uptake). In the 35 assessable patients, PET imaging after 14 days of therapy correctly predicted histopathologic response after 3 months of therapy in 10 (77%) of 13 responders and 19 (86%) of 22 nonresponders. Median overall survival for patients with a metabolic response has not been reached (2-year survival rate, 90%); for patients without a metabolic response, median survival was only 18.9 months (2-year survival rate, 25%; P =.002) |
2 |
| 91. Bilici A, Ustaalioglu BB, Seker M, et al. The role of 18F-FDG PET/CT in the assessment of suspected recurrent gastric cancer after initial surgical resection: can the results of FDG PET/CT influence patients' treatment decision making?. Eur J Nucl Med Mol Imaging. 38(1):64-73, 2011 Jan. |
Observational-Dx |
34 patients with suspected recurrent gastric cancer |
To evaluate the clinical role of FDG PET/CT in the detection of gastric cancer recurrence as compared with diagnostic CT and to assess the impact of FDG PET/CT results on patients' treatment planning. |
FDG PET/CT was performed in 19 patients (55.9%) due to the suspicion of distant metastasis at diagnostic CT. The remaining 15 patients were suspected to have local recurrence at diagnostic CT (n = 4) or gastroscopy (n = 1) and due to an increase in tumour markers or clinical manifestations (n = 10). The FDG PET/CT result was positive in 23 patients (67.6%) and negative in 11 patients (32.4%). In total, 24 (70.6%) of the 34 patients had documented recurrent disease by histopathology in 7 (29.1%) and by clinical follow-up in 17 (70.9%), while 11 patients had no evidence of recurrent disease. FDG PET/CT correctly confirmed recurrent disease in 23 of the patients with recurrence and it was classified as true-positive in these patients. However, FDG PET/CT was false-negative in one patient but recurrent disease was confirmed by histopathology. The overall sensitivity, specificity, accuracy, positive and negative predictive values of FDG PET/CT were significantly superior to those of diagnostic CT (95.8 vs 62.5%, 100 vs 10%, 97 vs 47%, 100 vs 62.5% and 90.9 vs 10%, respectively, p = 0.012) in the detection of recurrent gastric cancer after initial surgery. The FDG PET/CT results changed the patients' management in 18 (52.9%) cases by leading to the use of previously unplanned treatment procedures in 9 (50%) patients and the avoidance of previously planned therapeutic procedures in 9 (50%) patients. |
3 |
| 92. Wu LM, Hu JN, Hua J, Gu HY, Zhu J, Xu JR. 18 F-fluorodeoxyglucose positron emission tomography to evaluate recurrent gastric cancer: a systematic review and meta-analysis. [Review]. Journal of Gastroenterology & Hepatology. 27(3):472-80, 2012 Mar. |
Review/Other-Dx |
9 studies (526 patients) |
To explore the role of the diagnostic accuracy of (18) F-fluorodeoxyglucose positron emission tomography ((18) F-FDG PET) in detecting recurrent gastric cancer through a systematic review and meta-analysis. |
Across nine studies (526 patients), the overall sensitivity of (18) F-FDG PET was 0.78 (95% confidence interval [CI]: 0.68-0.86), and the overall specificity was 0.82 (95% CI: 0.76-0.87). Overall, LR+ was 3.52 (95% CI: 2.68-4.63) and LR- was 0.32 (95% CI: 0.22-0.46). In studies in which both (18) F-FDG PET and other diagnostic tests were performed, the sensitivity and specificity of (18) F-FDG PET were 0.72 (95% CI: 0.62-0.80) and 0.84 (95% CI: 0.77-0.90), respectively; of contrast CT, they were 0.74 (95% CI: 0.64-0.83) and 0.85 (95% CI: 0.78-0.90), respectively; and of combined PET and CT, they were 0.75 (95% CI: 0.67-0.82) and 0.85 (95% CI 0.79-0.90), respectively. Study sensitivity was not correlated with the prevalence of recurrent gastric cancer. |
4 |
| 93. Li P, Liu Q, Wang C, et al. Fluorine-18-fluorodeoxyglucose positron emission tomography to evaluate recurrent gastric cancer after surgical resection: a systematic review and meta-analysis. [Review]. Annals of Nuclear Medicine. 30(3):179-87, 2016 Apr. |
Review/Other-Dx |
828 |
We aimed to explore the diagnostic accuracy of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) for detection of gastric cancer recurrence after surgical resection through a systematic review and meta-analysis. |
On a per-patient basis, the forest plots showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of (18)F-FDG PET or PET/CT were 0.85 [95 % confidence interval (CI) 0.75-0.92], 0.78 (95 % CI 0.72-0.84), 3.9 (95 % CI 2.9-5.4), 0.19 (95 % CI 0.11-0.34), and 21 (95 % CI 9-47), respectively. On a per-lesion basis, the pooled sensitivity was 0.75 (95 % CI 0.61-0.86). The area under the SROC curve of PET/CT on the basis of per-patient was 0.86. (18)F-FDG PET had great value in the detection of gastric cancer recurrence after surgical resection. The sensitivities of (18)F-FDG PET were 85 and 75 %, respectively, on per-patient basis and on per-lesion basis. |
4 |
| 94. Lee DH, Kim SH, Im SA, Oh DY, Kim TY, Han JK. Multiparametric fully-integrated 18-FDG PET/MRI of advanced gastric cancer for prediction of chemotherapy response: a preliminary study. European Radiology. 26(8):2771-8, 2016 Aug. |
Observational-Dx |
11 |
To investigate usefulness of multiparametric fully integrated 18-FDG PET/MRI in predicting treatment response after chemotherapy for unresectable advanced gastric cancers (AGCs). |
After chemotherapy, six patients were classified into the responder group and five patients into the non-responder group. For all parameters, moderate to nearly perfect agreement was achieved (ICC = 0.452-0.911). K (trans) values (P = 0.018) and initial area under the curves (iAUCs) (P = 0.045) of gastric cancers were significantly higher in responder group than in non-responder group. The area under the curve was 0.917 for K (trans) and 0.867 for iAUC. However, SUVmax values were not significantly different between the two groups. |
2 |
| 95. Giganti F, De Cobelli F, Canevari C, et al. Response to chemotherapy in gastric adenocarcinoma with diffusion-weighted MRI and (18) F-FDG-PET/CT: correlation of apparent diffusion coefficient and partial volume corrected standardized uptake value with histological tumor regression grade. Journal of Magnetic Resonance Imaging. 40(5):1147-57, 2014 Nov. |
Observational-Dx |
17 |
To assess whether changes in diffusion-weighted MRI (DW-MRI) and (18) F-fluoro-2-deoxyglucose positron emission tomography/computed tomography ((18) F-FDG PET/CT), correlate with treatment response to neoadjuvant therapy (NT), as expressed by tumor regression grade (TRG), from locally advanced gastric adenocarcinoma (GA). |
Pre- and post-NT and percentage changes for ADC and PVC-SUVBW-mean were assessed. Post-NT ADC and ?ADC showed a significant inverse correlation with TRG (r = -0.71; P = 0.0011 and r = -0.78; P = 0.00020, respectively) and significant differences in their mean values were found between responders (TRG 1-2-3) and nonresponders (TRG 4-5) (P = 0.0009; P = 0.000082, respectively). No correlations with TRG were found for pre-NT ADC and for all PVC-SUVBW-mean values as well as between ?ADC and ? PVC-SUVBW-mean . |
2 |
| 96. Tanaka O, Yagi N, Tawada M, et al. Hemostatic Radiotherapy for Gastric Cancer: MRI as an Alternative to Endoscopy for Post-Treatment Evaluation. Journal of Gastrointestinal Cancer. 54(2):554-563, 2023 Jun. |
Observational-Tx |
8 patients who underwent hemostatic radiotherapy (RT) for gastric cancer |
To investigate the relationship among diffusion-weighted magnetic resonance imaging (DW-MRI), endoscopy, and tumor markers. |
Univariate analysis of overall survival showed that sex and chemotherapy treatment were statistically significant factors. The CEA values before and 1 month after RT decreased significantly. There was no statistical difference between the CEA value 1 and 3 months after RT. The ADC value before and 1 month after RT increased significantly but not between 1 and 3 months after RT. Comparing the ratio of ADC before RT to 1 (or 3) month(s) after RT with that of CEA before RT to 1 (or 3) month(s) after RT, we found an inverse relationship between the two ratios. |
2 |
| 97. Seo N, Han K, Hyung WJ, et al. Stratification of Postsurgical Computed Tomography Surveillance Based on the Extragastric Recurrence of Early Gastric Cancer. Annals of Surgery. 272(2):319-325, 2020 08. |
Observational-Dx |
430 |
To stratify the postsurgical computed tomography (CT) surveillance based on a risk-scoring system for predicting extragastric recurrence after surgical resection of early gastric cancer (EGC). |
The overall incidence of extragastric recurrence was 1.4% (44/3162). Five risk factors (lymph node metastasis, indications for endoscopic resection, male sex, positive lymphovascular invasion, and elevated macroscopic type), which were significantly associated with extragastric recurrence, were incorporated into the risk-scoring system, and the patients were categorized into 2 risk groups. The 10-year extragastric recurrence-free survival differed significantly between low- and high-risk groups (99.7% vs 96.5%; P < 0.001). The predictive accuracy of the risk-scoring system in the development cohort was 0.870 [Uno C-index; 95% confidence interval (95% CI), 0.800–0.939]. Discrimination was good after internal (0.859) and external validation (0.782, 0.549–1.000). |
3 |
| 98. Park CJ, Seo N, Hyung WJ, et al. Prognostic significance of preoperative CT findings in patients with advanced gastric cancer who underwent curative gastrectomy. PLoS ONE [Electronic Resource]. 13(8):e0202207, 2018. |
Observational-Dx |
419 |
To investigate preoperative prognostic stratification based on preoperative CT findings in patients with advanced gastric cancer in order to select high-risk patients who might benefit from neoadjuvant therapy |
Of total 394 patients, 86 patients (21.8%) experienced recurrence. Spiculated (=1mm) and nodular extramural tumor infiltration and CT size of 5-10cm were independent predictors of disease recurrence and significantly associated with worse DFS. Lymph node involvementon CT was not significantly associated with patient outcome. Among patients with same pT4a stage, the recurrence rate rises and DFS gets worse as the extramural tumor infiltration progresses (P < 0.001). The prediction model for recurrence revealed that size and CTtumor depth were the two major discriminating factors. |
2 |
| 99. Yang D, Zhou Y, Peng Z, Ou N. Effects of MSCT enhanced scan image diagnosis on clinical outcome of patients after radical gastrectomy and its influence on misdiagnosis rate. Journal of B.U.On.. 26(4):1479-1484, 2021 Jul-Aug. |
Observational-Dx |
62 patients diagnosed with gastric cancer and undergoing radical gastrectomy |
To explore the effect of multi-slice spiral computed tomography (MSCT) enhanced scan image diagnosis on clinical outcome of patients after radical gastrectomy and its influence on misdiagnosis rate. |
According to the results of gastroscopic biopsy, there were 35 cases suspected of recurrence, and 27 cases without postoperative recurrence. The specificity and sensitivity of conventional CT and MSCT enhanced scan were 85.19% vs. 92.59%, and 65.71% vs. 92.16%, respectively. Both specificity and sensitivity of MSCT enhanced scan were higher than those of conventional CT, with statistically significant differences (p<0.05). MSCT enhanced scan had a lower misdiagnosis rate for postoperative recurrence than conventional CT (5.71% vs. 22.86%) (p<0.05). Moreover, the negative predictive value and positive predictive value of conventional CT and MSCT enhanced scan were 65.71% vs. 86.21%, and 85.19% vs. 93.94%, respectively. The results showed that MSCT enhanced scan had higher negative predictive value and positive predictive value for postoperative recurrence than conventional CT, with statistically significant differences (p<0.05). |
3 |
| 100. Park CH, Kim EH, Chung H, et al. Role of computed tomography scan for the primary surveillance of mucosal gastric cancer after complete resection by endoscopic submucosal dissection. Surgical Endoscopy. 28(4):1307-13, 2014 Apr. |
Observational-Tx |
894 initial-onset early gastric cancers with two or more endoscopies with biopsy and one or more CT scans |
To analyze the clinical and long-term oncologic outcomes after gastric ESD to evaluate that abdominal CT scan is not essential for surveillance of mucosal gastric cancer after curative resection. |
The median follow-up period was 19.7 months (interquartile range, 11.3-35.4 months), during which time 81 lesions recurred. Of these, 35 recurred as an adenoma, whereas the others recurred as cancer. Of the 81 lesions that recurred, 79 were not diagnosed by abdominal CT scan but rather by endoscopy with biopsy. The remaining two lesions, which recurred as metachronous cancers, had suspicious CT scan findings, such as focal gastric wall thickening. The lesions also were confirmed by endoscopic biopsy, which was performed on the same day. None of the lesions was diagnosed by CT scan before pathologic confirmation by endoscopic biopsy. |
2 |
| 101. Choi KS, Kim SH, Kim SG, Han JK. Early Gastric Cancers: Is CT Surveillance Necessary after Curative Endoscopic Submucosal Resection for Cancers That Meet the Expanded Criteria?. Radiology. 281(2):444-453, 2016 Nov. |
Review/Other-Dx |
154 EGCs in 153 |
To determine the yield of follow-up abdominopelvic computed tomography (CT) in detecting extragastric recurrence after curative endoscopic submucosal dissection (ESD) for early gastric cancers (EGCs) that meet the expanded criteria. |
From a total of 2182 post-ESD CT examinations, extragastric recurrence (lymph node metastasis) was detected in only two patients (one with EGC that met conventional criteria and one with EGC that met expanded criteria). The mean (±standard deviation) volume CT dose index, dose-length product, and size-specific dose estimate per CT examination was 28.95 mGy ± 8.44, 876.80 mGy · cm ± 161.86, and 43.78 mGy ± 11.54, respectively. From a total of 3262 post-ESD endoscopic examinations, 41 gastric recurrences were detected (11 local recurrences and five synchronous and 25 metachronous gastric cancers). Among them, eight gastric recurrences were also detected with CT. The cumulative incidences of gastric recurrence 1, 3, and 5 years after ESD were 1.7% (two of 404 patients), 3.2% (13 of 404 patients), and 7.4% (30 of 404 patients), respectively. |
4 |
| 102. Jin Kim S, Kim TU, Woong Choi C, Gon Ryu D. Extragastric recurrence in patients who underwent surgical resection of stage I gastric cancer: Incidence, risk factors, and value of abdominal computed tomography as a postoperative surveillance method. Medicine. 101(37):e30335, 2022 Sep 16. |
Observational-Dx |
914 patients |
To investigate the incidence of extragastric recurrence, risk factors, and value of abdominal computed tomography (CT) as a surveillance method in patients who have undergone curative resection of stage I gastric cancer. |
This retrospective study enrolled 914 patients with stage I gastric cancer who underwent surgical resection at a single tertiary hospital. We investigated extragastric recurrence during the follow-up period, and disease-free survival (DFS) was assessed. Over a median follow-up period of 39 months, the overall incidence of extragastric recurrence was 2.2% (20/914). Risk factors for extragastric recurrence included deep submucosal invasion (SM2-3), muscularis propria invasion, and lymph node metastasis (hazard ratio [HR]=10.37, 28.101, and 6.843; P = .028, .002, and .001, respectively). Based on the number of risk factors, patients were stratified into 3 subgroups: low-risk (pT1aN0, pT1b(SM1)N0, 496/914), moderate-risk (pT1aN1, pT1b(SM1)N1, pT1b(SM2-3)N0, pT2N0, 369/914), and high-risk (pT1b(SM2-3)N1, 49/914). DFS was significantly longer in the low-risk group, followed by the moderate-risk and high-risk groups. |
3 |
| 103. Kim JH, Heo SH, Kim JW, et al. Evaluation of recurrence in gastric carcinoma: Comparison of contrast-enhanced computed tomography and positron emission tomography/computed tomography. World Journal of Gastroenterology. 23(35):6448-6456, 2017 Sep 21. |
Observational-Dx |
2475 patients who underwent both contrast-enhanced abdominal CT and FDG PET/CT for surveillance of gastric carcinoma curative resection |
To compare the value of contrast-enhanced abdominal computed tomography (CT) and fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for detecting gastric carcinoma recurrence. |
The pathological stage of the recurrence group was statistically significantly higher than that of the control group (P < 0.001). In the 60 patients who had recurrence, there were 79 recurrent lesions. Forty-four patients had only one location of recurrence, 13 patients had two locations, and 3 patients had three. In the detection of patient-based overall recurrence, no statistically significant differences existed between the two modalities (P = 0.096). However, for peritoneal carcinomatosis, CT had a statistically significantly higher sensitivity compared to PET/CT (96% vs 50%, P = 0.001). Adenocarcinoma was the most common type of gastric carcinoma. On the pathology-based analysis, CT also had a statistically significantly higher sensitivity compared to PET/CT (98% vs 80%, P = 0.035). |
3 |
| 104. Lee JW, Lee SM, Lee MS, Shin HC. Role of 18F-FDG PET/CT in the prediction of gastric cancer recurrence after curative surgical resection. European Journal of Nuclear Medicine & Molecular Imaging. 39(9):1425-34, 2012 Sep. |
Review/Other-Dx |
271 patients |
To evaluate the role of preoperative (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in the prediction of recurrent gastric cancer after curative surgical resection. |
Of 271 patients, 47 (17 %) had a recurrent event. Positive (18)F-FDG cancer uptake was shown in 149 patients (55 %). Tumour size, depth of invasion, presence of lymph node metastasis, positive (18)F-FDG uptake and SUV(max) were significantly associated with tumour recurrence in univariate analysis, while only depth of invasion, positive (18)F-FDG uptake and SUV(max) had significance in multivariate analysis. The 24-month recurrence-free survival rate was significantly higher in patients with negative (18)F-FDG uptake (95 %) than in those with positive (18)F-FDG uptake (74 %; p < 0.0001). In subgroup analysis, (18)F-FDG uptake was a significant prognostic factor in patients with tubular adenocarcinoma (p = 0.003) or poorly differentiated adenocarcinoma (p = 0.0001). However, only marginal significance was shown in patients with signet-ring cell carcinoma and mucinous carcinoma (p = 0.05). |
4 |
| 105. Lee JW, Lee SM, Son MW, Lee MS. Diagnostic performance of FDG PET/CT for surveillance in asymptomatic gastric cancer patients after curative surgical resection. European Journal of Nuclear Medicine & Molecular Imaging. 43(5):881-888, 2016 May. |
Review/Other-Dx |
109 |
To evaluate the diagnostic performance of 2-[(18)F] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) for surveillance in asymptomatic gastric cancer patients after curative surgical resection. |
During follow-up, 19 patients (10.0 %) developed recurrence. FDG PET/CT showed abnormal findings in 37 patients (19.5 %). Among them, 16 patients (8.4 %) were diagnosed as cancer recurrence. Of 153 patients without abnormal findings on PET/CT, three patients were false-negative and diagnosed as recurrence on other follow-up examinations. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG PET/CT were 84.2 %, 87.7 %, 43.2 %, and 98.0 %, respectively. Among 115 early gastric cancer patients, PET/CT detected recurrence in four patients (3.5 %) and one patient with local recurrence. Among 75 advanced gastric cancer patients, PET/CT detected recurrence in 12 patients (16.0 %), excluding two patients experiencing peritoneal recurrence. In addition, FDG PET/CT detected secondary primary cancer in six (3.2 %) out of all the patients. |
4 |
| 106. Zou H, Zhao Y. 18FDG PET-CT for detecting gastric cancer recurrence after surgical resection: a meta-analysis. [Review]. Surgical Oncology. 22(3):162-6, 2013 Sep. |
Meta-analysis |
8 studies
500 patients |
To evaluate the value of (18)FDG PET-CT for the detection of gastric cancer recurrence after surgical resection. |
Eight studies (500 patients) were included. The sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of (18)FDG PET-CT were 0.86 (95% confidence interval [CI] = 0.71-0.94), 0.88 (95% CI = 0.75-0.94), 17.0 (95% CI = 3.5-14.0), and 0.16 (95% CI = 0.07-0.34), respectively. Overall weighted area under the curve was 0.93 (95% CI = 0.91-0.95). |
Not Assessed |
| 107. Malibari N, Hickeson M, Lisbona R. PET/Computed Tomography in the Diagnosis and Staging of Gastric Cancers. [Review]. Pet Clinics. 10(3):311-26, 2015 Jul. |
Review/Other-Dx |
N/A |
PET/CT in the evaluation and staging of gastric cancer is not established, |
No results stated in abstract. |
4 |
| 108. Cayvarli H, Bekis R, Akman T, Altun D. The Role of 18F-FDG PET/CT in the Evaluation of Gastric Cancer Recurrence. Mol Imaging Radionucl Ther 2014;23:76-83. |
Observational-Dx |
130 patients |
To assess the diagnostic performance of 18F-FDG PET/CT for detecting recurrence in gastric cancer patients with radiologic or clinical suspicion of recurrence and its clinical impact on making decision. |
Of all 130 patients, 91 patients were confirmed to have true recurrence. The sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of PET/CT for diagnosing true recurrence on a per-person basis were 91.2%, 61.5%, 84.6%, 75.0% and 82.3% respectively. Final diagnoses were confirmed histopathologically in 59 (45.4%) of 130 patients and by clinical and radiological follow-up in the remaining 71 (54.6%) patients. In the subgroup with SRC/mucinous adenocarcinoma differentiation of the primary tumor, there was no statistically significant difference in terms of diagnostic accuracy of PET/CT on a per-person basis. In addition, PET/CT results changed the patients' management in 20 (15%) cases. |
3 |
| 109. Kim DW, Park SA, Kim CG. Detecting the recurrence of gastric cancer after curative resection: comparison of FDG PET/CT and contrast-enhanced abdominal CT. Journal of Korean Medical Science. 26(7):875-80, 2011 Jul. |
Review/Other-Dx |
139 patients |
To evaluate the value of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for detecting the recurrence of gastric cancer. |
Recurrence of gastric cancer was validated by histopathologic examination for local recurrence or serial imaging study follow-up with at least 1 yr interval for recurrence of distant metastasis form. Twenty-eight patients (20.1%) were confirmed as recurrence. On the patient based analysis, there was no statistically significant difference in the sensitivity, specificity and accuracy of PET/CT (53.6%, 84.7%, and 78.4%, respectively) and those of CECT (64.3%, 86.5%, and 82.0%, respectively) for detecting tumor recurrence except in detection of peritoneal carcinomatosis. Among 36 recurrent lesions, 8 lesions (22.2%) were detected only on PET/CT, and 10 lesions (27.8%) only on CECT. PET/CT had detected secondary malignancy in 8 patients. PET/CT is as accurate as CECT in detection of gastric cancer recurrence after curative resection, excepting detection of peritoneal carcinomatosis. Moreover, additional PET/CT on CECT could improve detection rate of tumor recurrence and provide other critical information such as unexpected secondary malignancy. |
4 |
| 110. Sun G, Cheng C, Li X, Wang T, Yang J, Li D. Metabolic tumor burden on postsurgical PET/CT predicts survival of patients with gastric cancer. Cancer Imaging. 19(1):18, 2019 Mar 22. |
Review/Other-Dx |
376 patients |
To investigate the prognostic value of whole body (WB) metabolic tumor burden (MTBWB) on postsurgical 18F-FDG PET/CT to patients with gastric cancer. |
The PET-positive patients had significantly decreased OS based on either Kaplan-Meier survival analysis (P < 0.001) or univariable Cox regression (hazard ratio [HR] = 2.850, P < 0.001). In patients with PET-positive tumors, the associations between OS and SUVWBmax, MTVWB and TLGWB were significant, both in univariable analysis (P < 0.001, P < 0.001 and P = 0.001, respectively) and in multivariable analysis (P = 0.002, P < 0.001 and P = 0.005, respectively). Patient OS among groups dichotomized by cutoffs of SUVWBmax > 8.6, MTVWB > 91.5 cm3, and TLGWB > 477.6 cm3 were significantly different (P = 0.001, P < 0.001 and P = 0.001, respectively). |
4 |
| 111. Turkoz FP, Solak M, Kilickap S, et al. Bone metastasis from gastric cancer: the incidence, clinicopathological features, and influence on survival. J Gastric Cancer 2014;14:164-72. |
Review/Other-Dx |
176 patients |
To evaluate the incidence, clinicopathological characteristics, treatment outcomes, prognostic factors, and survival of gastric cancer patients with bone metastases. |
The incidence of bone metastasis was 3.8%. The most common histopathological subtype was adenocarcinoma (79%) with poor differentiation (60.8%). The median interval from the diagnosis to bone metastasis was 11 months. The median survival time after bone metastasis was 5.4 months. Factors that were associated with longer median survival times included the following: isolated bone metastasis (P=0.004), well-differentiated tumors (P=0.002), palliative chemotherapy (P=0.003), zoledronic acid treatment (P<0.001), no smoking history (P=0.007), and no metastatic gastric cancer at the time of diagnosis (P=0.01). On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times. In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors. |
4 |
| 112. Lee JW, Lee MS, Chung IK, Son MW, Cho YS, Lee SM. Clinical implication of FDG uptake of bone marrow on PET/CT in gastric cancer patients with surgical resection. World Journal of Gastroenterology. 23(13):2385-2395, 2017 Apr 07. |
Review/Other-Dx |
309 patients |
To determine the relationship between F-18 fluorodeoxyglucose (FDG) uptake of bone marrow (BM) on positron emission tomography/computed tomography (PET/CT) and clinical factors and to assess the prognostic value of FDG uptake of BM in gastric carcinoma. |
Of 309 patients, 38 patients (12.3%) experienced cancer recurrence and 18 patients (5.8%) died. Patients with advanced gastric cancer, positive FDG uptake, and recurrence had higher values of BM SUV and BLR than those with early gastric cancer, negative FDG uptake, and no recurrence (P < 0.05). BM SUV and BLR were significantly correlated with hemoglobin level, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (P < 0.05). On multivariate analysis, multiple tumors, T stage, lymph node metastasis, tumor involvement of resection margin, and BLR were significantly associated with RFS (P < 0.05). T stage, lymph node metastasis, hemoglobin level, and BLR were significantly associated with OS (P < 0.05). |
4 |
| 113. Measuring Sex, Gender Identity, and Sexual Orientation. |
Review/Other-Dx |
N/A |
Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized. |
No abstract available. |
4 |
| 114. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/Clinical/Appropriateness-Criteria/ACR-Appropriateness-Criteria-Radiation-Dose-Assessment-Introduction.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
