Value of Multidetector-Row Computed Tomography in the Preoperative T and N Staging of Gastric Carcinoma: A Large-Scale Chinese Study

Objectives: To investigate the value of multidetector-row Computed tomography (MDCT) in the preoperative T and N staging of gastric carcinoma and to further investigate the clinicopathotogical factors affecting the diagnostic accuracy. Methods: Seven hundred ninety gastric carcinoma patients underwent preoperative MDCT examination. The results of MDCT were compared with surgical and pathological findings. Results: Early gastric carcinoma patients whose primary tumor was detected by MDCT had higher incidence of lymph node metastasis, larger tumor size, and deeper invasion. The overall accuracy of MDCT in determining T stage of gastric carcinoma was 73.80% (T1 45.93%, T2 53.03%, T3 86.49%, and T4 85.79%). The overall accuracy of MDCT in preoperative N staging was 75.22% (N0 76.17%, N1 68.81%, and N2 80.63%). The overall diagnostic sensitivity, specificity, and accuracy of MDCT for determining lymph node metastasis was 86.26%, 76.17%, and 82.09%, respectively. Multivariate analysis showed that the diagnostic sensitivity of MDCT in determining lymph node metastasis related with tumor size, N stage, and number of metastatic lymph nodes. Conclusions: The clinical value of MDCT in the preoperative T and N staging of gastric carcinoma is relatively high. MDCT can be the first choice for the preoperative evaluation of patients with gastric carcinoma. J. Surg. Oncol 2009;100:205-214. (C) 2009 Wiley-Liss, Inc.