Diagnostic Accuracy of Multidetector Row Computed Tomography in T- and N Staging of Gastric Cancer With Histopathologic Correlation

PURPOSE: To evaluate the diagnostic accuracy of multidetector row computed tomography (MDCT) for the preoperative T- and N staging of gastric cancer. MATERIALS AND METHODS: Eighty-four consecutive patients with gastric cancer underwent preoperative MDCT. Except for 15 patients who did not undergo surgery, 69 patients were included in our study. Two radiologists independently evaluated the T- and N staging on the axial CT images alone and in combination with the MPR images. For N staging, the new TNM and Japanese classifications were independently used. Differences in staging accuracy for T- and N staging were assessed using the McNemar test. RESULTS: The overall T staging accuracy of the axial and combined axial and MPR images was as follows: 67% (47 of 70 cancers) versus 77% (54 of 70 cancers) (P=0.039). The overall N staging accuracy of the axial and combined axial and MPR images was as follows: 59% (41 of 69 cancers) versus 67% (46 of 69 cancers) (P=0.180, Japanese classification) and 54% (37 of 69 cancers) versus 59% (41 of 69 cancers) (P=0.109, TNM classification). CONCLUSIONS: Using MPR images enables more accurate preoperative T staging of gastric cancer, but not for N staging in either classification system.