This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kwee, R. M. Articles by Kwee, T. C. Search for Related Content PubMed PubMed Citation Articles by Kwee, R. M. Articles by Kwee, T. C.

Imaging in Local Staging of Gastric Cancer: A Systematic Review

Robert Michael Kwee, Thomas Christian Kwee

From the Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands

Address reprint requests to Robert M. Kwee, MD, University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; e-mail: rmkwee{at}gmail.com

Purpose: Endoscopic ultrasound (EUS) has been established as the diagnostic modality of choice in local (T) staging of gastric cancer. Multidetector row computed tomography (MDCT) and magnetic resonance imaging (MRI) are promising alternatives. The aim of this study was to systematically review the literature regarding the performance of each of these imaging modalities.

Methods: A systematic search for relevant studies was performed in the PubMed/MEDLINE and EMBASE databases. Two reviewers independently assessed the methodological quality of each study. Local staging performance of included studies was calculated.

Results: Twenty-two EUS studies, five MDCT studies, one combined EUS and MDCT study, and three MRI studies met the inclusion criteria. The studies were of moderate methodological quality. Diagnostic accuracy of overall T staging for EUS, MDCT, and MRI varied between 65% to 92.1%, 77.1% to 88.9%, and 71.4% to 82.6%, respectively. Sensitivity for assessing serosal involvement for EUS, MDCT, and MRI varied between 77.8% to 100%, 82.8% to 100%, and 89.5% to 93.1%, respectively. Specificity for assessing serosal involvement for EUS, MDCT, and MRI varied between 67.9% to 100%, 80% to 96.8%, and 91.4% to 100%, respectively.

Conclusion: EUS, MDCT, and MRI achieve similar results in terms of diagnostic accuracy in T staging and in assessing serosal involvement. Most experience has been gained with EUS. Few MDCT studies and even fewer MRI studies are available. Thus, EUS remains the first-choice imaging modality in preoperative T staging of gastric cancer.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.