Differentiation of early gastric cancer with ulceration and resectable advanced gastric cancer using multiphasic dynamic multidetector CT

Daisuke Tsurumaru, Mitsutoshi Miyasaka, Yusuke Nishimuta, Yoshiki Asayama, Akihiro Nishie, Satoshi Kawanami, Eiji Oki, Minako Hirahashi, Hiroshi Honda

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)

Abstract

Objectives: Early gastric cancer with ulceration (EGC-U) mimics advanced gastric cancer (AGC), as EGC-Us and ACGs often have similar endoscopic appearance to ulceration. The purpose of this retrospective study was to determine whether multiphasic dynamic multidetector CT (MDCT) can help differentiate EGC-Us from AGCs. Methods: Patients with EGC-Us with ulcer stages Ul-III or IV and AGCs with tumour stages T2 to T4a were enrolled. MDCT images were obtained 40 s (arterial phase), 70 s (portal phase) and 240 s (delayed phase) after injection of non-ionic contrast material. Two readers independently measured the attenuation values of the lesions by placing regions of interest. We compared the EGC-Us and AGCs using the mean attenuation values in each phase and peak enhancement phase. We analysed the diagnostic performance of CT for differentiating EGC-Us from AGCs. Results: Forty cases (16 EGC-Us and 24 AGCs) were analysed. The mean attenuation values of the EGC-Us were significantly lower than those of the AGCs in both the arterial and portal phases (all p < 0.0001 for each reader). The peak enhancement was significantly different between the EGC-Us and AGCs for both readers (Reader 1, p = 0.0131; Reader 2, p = 0.0006). Conclusion: Multiphasic dynamic contrast-enhanced MDCT can help differentiate EGC-Us from AGCs. Key Points: • Early gastric cancer with ulceration and advanced gastric cancer have similar endoscopic appearances. • EGC-U shows significantly lower attenuation values in both arterial and portal phases. • Multiphasic dynamic contrast-enhanced MDCT differentiates EGC-U from AGC.

Original languageEnglish
Pages (from-to)1330-1337
Number of pages8
JournalEuropean Radiology
Volume26
Issue number5
DOIs
Publication statusPublished - May 1 2016

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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