Value of spiral CT plus endoscopic ultrasonography (EUS) and spiral CT plus PET-CT in the preoperative assessment of gastric cancer invasion to the pancreas.
- Author:
Wu SONG
1
;
Yu-long HE
;
Chang-hua ZHANG
;
Shi-rong CAI
;
Xue-fu ZHOU
;
Jian-jun PENG
;
Wen-hua ZHAN
Author Information
- Publication Type:Journal Article
- MeSH: Adenocarcinoma; diagnosis; pathology; Adenocarcinoma, Mucinous; diagnosis; pathology; Aged; Carcinoma, Signet Ring Cell; diagnosis; pathology; Endosonography; Female; Humans; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Pancreas; pathology; Positron-Emission Tomography; Preoperative Period; Prospective Studies; Stomach Neoplasms; diagnosis; pathology; Tomography, Spiral Computed
- From: Chinese Journal of Oncology 2009;31(5):371-374
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the value of EUS and PET-CT in combination with spiral CT in preoperative assessment of gastric cancer invasion to the pancreas.
METHODSSixty advanced gastric cancer patients with suspected pancreatic invasion detected by spiral CT were selected in this study. All the 60 cases were then examined by EUS and 14 of them by PET-CT. The results were compared and evaluated with the findings during surgical operation and pathological results.
RESULTSThe rate of correct preoperative diagnosis of pancreatic invasion by spiral CT in advanced gastric cancer patients was 63.3%, with an overdiagnosis rate of 36.7%. The diagnostic accuracy was increased to 87.8% and overdiagnosis reduced to 7.3%, when combined with EUS. There was a significant difference in diagnostic accuracy between spiral CT alone and spiral CT combined with EUS (P<0.01), but no significant difference between spiral CT alone and spiral CT combined with PET-CT (P>0.05). Spiral CT-EUS was more valuable in assessment of tumor location and invasion than PET-CT (P<0.01).
CONCLUSIONThe accuracy of spiral CT alone in the preoperative assessment of advanced gastric cancer with invasion to the pancreas is not high enough yet at present. Spiral CT combined with EUS can provide more accurate information on the tumor location, invasion site and extent of gastric cancer invasion to the pancreas, and reduce the overstaging rate caused by spiral CT alone. However, spiral CT combined with PET-CT does not show such improvement significantly.
