Accuracy of multidetector-row CT in diagnosing lymph node metastasis in patients with gastric cancer

Takuro Saito, Yukinori Kurokawa, Shuji Takiguchi, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Makoto Yamasaki, Hiroshi Miyata, Kiyokazu Nakajima, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)

Abstract

Objectives: The purpose of this study was to determine the optimal cut-off value of lymph node size for diagnosing metastasis in gastric cancer with multidetector-row computed tomography (MDCT) after categorizing perigastric lymph nodes into three regions.

Methods: The study included 90 gastric cancer patients who underwent gastrectomy. The long-axis diameter (LAD) and short-axis diameter (SAD) of all visualized lymph nodes were measured with transverse MDCT images. The locations of lymph nodes were categorized into three regions: lesser curvature, greater curvature, and suprapancreatic. The diagnostic value of lymph node metastasis was assessed with receiver operating characteristic (ROC) analysis.

Results: The area under the curve was larger for SAD than LAD in all groups. The optimal cut-off values of SAD were determined as follows: overall, 9 mm; differentiated type, 9 mm; undifferentiated type, 8 mm; lesser curvature region, 7 mm; greater curvature region, 6 mm; and suprapancreatic region, 9 mm. The diagnostic accuracies for lymph node metastasis using individual cut-off values were 71.1 % based on histological type and 76.6 % based on region of lymph node location.

Conclusions: The diagnostic accuracy of lymph node metastasis in gastric cancer was improved by using individual cut-off values for each lymph node region.

Key points: • Multidetector-row computed tomography is widely used to predict pathological nodal status.

• An optimal cut-off value of lymph node size has not been determined.

• Cut-off values were assessed according to histology and nodal location.

• The optimal cut-off values differed based on histology and nodal location.

• Diagnostic accuracy was improved by using individual cut-off values for each region.

Original languageEnglish
Pages (from-to)368-374
Number of pages7
JournalEuropean Radiology
Volume25
Issue number2
DOIs
Publication statusPublished - 2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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