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.
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Abbreviations
- MDCT:
-
multidetector-row computed tomography
- LAD:
-
long-axis diameter
- SAD:
-
short-axis diameter
- ROC:
-
receiver operating characteristics
- AUC:
-
area under the curve
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Acknowledgements
The scientific guarantor of this publication is Yuichiro Doki. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval and written informed consent were not required because this is a retrospective diagnostic study.. A written informed consent for preoperative staging with MDCT was obtained from all patients. Methodology: retrospective diagnostic or prognostic study, performed at one institution
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Saito, T., Kurokawa, Y., Takiguchi, S. et al. Accuracy of multidetector-row CT in diagnosing lymph node metastasis in patients with gastric cancer. Eur Radiol 25, 368–374 (2015). https://doi.org/10.1007/s00330-014-3373-9
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DOI: https://doi.org/10.1007/s00330-014-3373-9