Diagnosis and t-staging of gastric cancer: comparison of standard computed tomography and computed-tomographic pneumogastrography

2021 ◽  
Vol 23 (2) ◽  
pp. 99-106
Author(s):  
Inna D. Amelina ◽  
Lev N. Shevkunov ◽  
Aleksey M. Karachun ◽  
Alexander E. Mikhnin ◽  
Denis V. Nesterov
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Three Dimensional ◽  
High Sensitivity ◽  
Subtotal Resection ◽  
Standard Protocol ◽  
Computed Tomographic ◽  
T Stage ◽  
Significant Difference ◽  
Virtual Gastroscopy

The advantages of computed tomographic pneumogastrography with the possibility of three-dimensional visualization and virtual gastroscopy in diagnosing gastric cancer are considered. The study included 479 patients with histologically diagnosed gastric cancer who were treated at the National Medical Research Center of Oncology named after N.N. Petrov from 2011 to 2018. 232 patients received preoperative chemotherapy. All patients underwent surgery: 70 in the volume of endoscopic dissection, 40 proximal subtotal resection, 166 distal subtotal resection, 203 gastrectomy. All patients at the preoperative stage underwent staging computed tomography on a 64-slice X-ray computed tomograph: 208 patients underwent computed tomography according to the standard protocol without targeted preparation of the stomach for the study, 271 patients with targeted preparation of the stomach for the study according to the computed tomographic pneumogastrography protocol. The sensitivity of the computed tomography in assessing the T-stage was assessed by comparison with pathomorphological data. Of the 208 patients who underwent computed tomography according to the standard protocol, a gastric cancer was detected in 111 (53.4%), out of 271 patients who underwent computed tomography pneumogastrography, a gastric cancer was detected in 267 (98.52%), which is a statistically significant difference in comparing computed tomography methods (Pearson, 144.223, df = 1; p 0.001). There are statistically significant differences when comparing computed tomography according to the standard protocol and computed tomographic pneumogastrography in detecting gastric cancer for all tumor categories: T/yT1 8.2 and 94.4% (Pearson, 99.205, df = 1; p 0.001), T/yT2 47.8 and 100% (Pearson, 24.681, df = 1; p 0.001), T/yT3 72.3 and 100% (Pearson, 33.114, df = 1; p 0.001), T/yT4 90.0 and 100% (Pearson, 4.789, df = 1; p = 0.029) respectively. There are also statistically significant differences when comparing the sensitivity of computed tomography according to the standard protocol and computed tomographic pneumogastrography in determining tumor invasion for all tumor categories: T/yT1 0 and 69.4% (Pearson, 67.880, df = 1; p 0.001), T/yT2 26.1 and 71.1% (Pearson, 11.666, df = 1; p 0.001), T/yT3 32.9 and 84.6% (Pearson, 54.900, df = 1; p 0.001), T/yT4 73.3 and 95.7% (Pearson, 7.916, df = 1; p = 0.005) respectively. In general, the sensitivity of the computed tomography according to the standard protocol for determining the T-stage of gastric cancer was 28.4%, computed tomographic pneumogastrography 77.1% (Pearson, 113.505, df = 1; p 0.001). Computed tomographic pneumogastrography with the possibility of three-dimensional visualization and virtual gastroscopy significantly increases the indicators of the effectiveness of diagnosing gastric cancer both early forms (category T1) and with deeper invasion (categories T2T4), demonstrates high sensitivity in determining T/yT-stages.

scholarly journals Evaluation of mandibular volume classified by vertical skeletal dimensions with cone-beam computed tomography

2016 ◽  
Vol 86 (6) ◽  
pp. 949-954 ◽  
Author(s):  
Takatoshi Nakawaki ◽  
Tetsutaro Yamaguchi ◽  
Daisuke Tomita ◽  
Yu Hikita ◽  
Mohamed Adel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Three Dimensional ◽  
Cone Beam ◽  
Class Iii ◽  
Tomographic Images ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Detailed Assessment ◽  
Lateral Cephalometry

ABSTRACT Objective: To investigate the relationship between anteroposterior and vertical differences in maxillofacial morphology and mandibular volume. Materials and Methods: Subjects comprised 213 Japanese adults (84 males and 129 females) who were divided into three groups based on mandibular basal arch (ANB) and Wits, measured in a cephalometric analysis: Class I (−1° ≤ ANB < 4°,−1 mm ≤ Wits < 0 mm), Class II (ANB ≥ 4°, Wits ≥ 0), and Class III (ANB <−1°, Wits <−1 mm). Subjects were also divided into three groups based on the mandibular plane angle (Mp), as follows: hypodivergent (Mp < 23°), normodivergent (Mp  =  23–30°), and hyperdivergent (Mp > 30°) groups. Mandibular volume was measured from cone-beam computed tomographic images that were analyzed using Analyze™ image processing software and compared among the three groups in each classification. Results: No significant differences were noted in mandibular volume among Classes I, II, and III. An inverse relationship was found between mandibular volume and Mp, and a significant difference was noted in mandibular volume between the hypodivergent and hyperdivergent groups. Conclusions: In addition to two-dimensional analysis, such as lateral cephalometry, three-dimensional information such as volume, provided by cone-beam computed tomography, contributes to a more detailed assessment of maxillofacial morphology.

scholarly journals Computed tomography pneumogastrography in determining clinical t-stage and yt-stage of gastric cancer

2021 ◽  
Vol 67 (5) ◽  
pp. 675-682
Author(s):  
Inna Amelina ◽  
Lev Shevkunov ◽  
Alexey Karachun ◽  
Anastasia Muravtseva ◽  
Alexander Mikhnin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Preoperative Chemotherapy ◽  
Locally Advanced ◽  
Fibrous Tissue ◽  
Subtotal Gastrectomy ◽  
Subtotal Resection ◽  
Depth Of Invasion ◽  
T Stage ◽  
National Medical

Оbjective. To assess the sensitivity of CT pneumogastrography in determining the T-stage and yT-stage. Materials and methods. This is a prospective, single-center study that included 267 patients with a histologically diagnosed stomach cancer who received treatment at the N.N. Petrov National Medical Research Center of Oncology from 2015 to 2018. 162 (60.7%) patients underwent preoperative chemotherapy. All patients underwent surgery: 22 in the volume of proximal subtotal gastrectomy, 95 in the volume of distal subtotal resection, 123 in the volume of gastrectomy, and 27 in the volume of endoscopic dissection. All patients underwent staging computed tomography at the preoperative stage according to a single protocol - CT pneumogastrography on a 64-slice X-ray computed tomography. The sensitivity of the method in assessing the depth of invasion was calculated separately for patients without preoperative chemotherapy (T-stage) and for patients who underwent preoperative chemotherapy (уT-stage) by comparison with pathological data. Results. The sensitivity indicators of CT pneumogastrography for patients without preoperative chemotherapy were: for T1a – 80.6%, T1b – 72.7%, T2 – 80.0%, T3 – 88.0%, T4a – 83.3%, T4b –100%. The sensitivity indicators of CT pneumogastrography for patients receiving preoperative chemotherapy were: for уT2 – 65.2%, уT3 – 83.5%, уT4a – 83.9%, уT4b – 75.0%. It is difficult to restore locally advanced gastric cancer with a depth of invasion cT2 – cT4b in the category yT0, yT1a, and yT1b after preoperative chemotherapy due to the persisting pathological tissue with impaired differentiation of all layers of the stomach wall, which is pathomorphologically a large fibrous tissue. Сonclusion. CT-pneumogastrography demonstrates high diagnostic indicators in determining the T-stage and yT-stage of gastric cancer.    

scholarly journals Gastric Cancer Imaging: Computed Tomographic Pneumogastrography

2021 ◽  
Vol 102 (3) ◽  
pp. 155-165
Author(s):  
I. D. Amelina ◽  
L. N. Shevkunov ◽  
A. M. Karachun ◽  
A. L. Muravtseva ◽  
A. S. Artemyeva
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Gastric Resection ◽  
Locally Advanced ◽  
Morphological Type ◽  
Invasion Depth ◽  
Computed Tomographic ◽  
National Medical ◽  
Virtual Gastroscopy

Objective: to reveal technical nuances for obtaining high-quality images using a computed tomography protocol with pneumogastrography and virtual gastroscopy, which contribute to the detection and assessment of the morphological type of gastric cancer and to the determination of its localization and invasion depth.Material and methods. The investigation enrolled 250 patients with both early (24.8%) and locally advanced (75.2%) gastric cancer treated in Petrov National Medical Research Center for Oncology from 2015 to 2018. Preoperative chemotherapy was performed in 142 (56.8%) patients and was not done in 108 (43.2%). All the patients underwent preoperative computed tomography with pneumogastrography and virtual gastroscopy. All the patients were radically operated on through subtotal or total gastric resection.Results. Computed tomography with pneumogastrography and virtual gastroscopy was used to detect gastric cancer in 98.4% of patients; the cases with early T1a and T1b invasion depth cancers were 23.2%. The tumor could not be significantly differentiated in 4 (1.6%) patients. This group consisted of: 3 (1.2%) and 1 (0.4%) patients with pT1a and pT1b invasion depth tumors, respectively. All non-visualized tumors had a superficial morphological type of growth (Type 0–II (3 cases with 0–IIa and 1 case with 0–IIb); their sizes were less than 2 cm. Three tumors were localized in the antral portion of the stomach; one was in its cardiac portion.Conclusion. Computed tomography with pneumogastrography and virtual gastroscopy is an effective technique to detect gastric cancer, including its early types of category T1, which makes it possible to assess its localization, morphological type, and invasion depth.

scholarly journals Three-dimensional assessment of the anterior and inferior loop of the inferior alveolar nerve using computed tomography images in patients with and without mandibular asymmetry

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jae-Young Kim ◽  
Michael D. Han ◽  
Kug Jin Jeon ◽  
Jong-Ki Huh ◽  
Kwang-Ho Park
Keyword(s):  
Computed Tomography ◽  
Symmetry Group ◽  
Three Dimensional ◽  
Inferior Alveolar Nerve ◽  
Mental Foramen ◽  
3D Analysis ◽  
Mandibular Asymmetry ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Mandibular Body

Abstract Background The purpose of this study was to investigate the differences in configuration and dimensions of the anterior loop of the inferior alveolar nerve (ALIAN) in patients with and without mandibular asymmetry. Method Preoperative computed tomography images of patients who had undergone orthognathic surgery from January 2016 to December 2018 at a single institution were analyzed. Subjects were classified into two groups as “Asymmetry group” and “Symmetry group”. The distance from the most anterior and most inferior points of the ALIAN (IANant and IANinf) to the vertical and horizontal reference planes were measured (dAnt and dInf). The distance from IANant and IANinf to the mental foramen were also calculated (dAnt_MF and dInf_MF). The length of the mandibular body and symphysis area were measured. All measurements were analyzed using 3D analysis software. Results There were 57 total eligible subjects. In the Asymmetry group, dAnt and dAnt_MF on the non-deviated side were significantly longer than the deviated side (p < 0.001). dInf_MF on the non-deviated side was also significantly longer than the deviated side (p = 0.001). Mandibular body length was significantly longer on the non-deviated side (p < 0.001). There was no significant difference in length in the symphysis area (p = 0.623). In the Symmetry group, there was no difference between the left and right sides for all variables. Conclusion In asymmetric patients, there is a difference tendency in the ALIAN between the deviated and non-deviated sides. In patients with mandibular asymmetry, this should be considered during surgery in the anterior mandible.

A volumetric three-dimensional evaluation of invasiveness of an endoscopic and microscopic approach for transmeatal visualisation of the middle ear

2021 ◽  
pp. 1-5
Author(s):  
A H A Baazil ◽  
J G G Dobbe ◽  
E van Spronsen ◽  
F A Ebbens ◽  
F G Dikkers ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Middle Ear ◽  
Three Dimensional ◽  
Endoscopic Approach ◽  
Microscopic Approach ◽  
Significant Difference ◽  
Computed Tomography Scans ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Abstract Objective This study aimed to compare the necessary scutum defect for transmeatal visualisation of middle-ear landmarks between an endoscopic and microscopic approach. Method Human cadaveric heads were used. In group 1, middle-ear landmarks were visualised by endoscope (group 1 endoscopic approach) and subsequently by microscope (group 1 microscopic approach following endoscopy). In group 2, landmarks were visualised solely microscopically (group 2 microscopic approach). The amount of resected bone was evaluated via computed tomography scans. Results In the group 1 endoscopic approach, a median of 6.84 mm3 bone was resected. No statistically significant difference (Mann–Whitney U test, p = 0.163, U = 49.000) was found between the group 1 microscopic approach following endoscopy (median 17.84 mm3) and the group 2 microscopic approach (median 20.08 mm3), so these were combined. The difference between the group 1 endoscopic approach and the group 1 microscopic approach following endoscopy plus group 2 microscopic approach (median 18.16 mm3) was statistically significant (Mann–Whitney U test, p < 0.001, U = 18.000). Conclusion This study showed that endoscopic transmeatal visualisation of middle-ear landmarks preserves more of the bony scutum than a microscopic transmeatal approach.

scholarly journals Radiographic and computed tomographic assessment of the development of the antebrachia and elbow joints in Labrador Retrievers with and without medial coronoid disease

2015 ◽  
Vol 28 (03) ◽  
pp. 186-192 ◽  
Author(s):  
H. A. W. Hazewinkel ◽  
G. Voorhout ◽  
S. F. Lau
Keyword(s):  
Computed Tomography ◽  
Growth Stage ◽  
Length Ratio ◽  
Active Growth ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Secondary Ossification Centres ◽  
A Prospective Study ◽  
Joint Congruence ◽  
Labrador Retrievers

SummaryObjectives: To compare the development, monitored by radiography and computed tomography, of the antebrachia and elbow joints in seven Labrador Retrievers with healthy elbow joints and in seven Labrador Retrievers that developed medial coronoid disease (MCD), in order to determine whether disturbances in the development of the antebrachia and elbow joints, between the age of six and 17 weeks may lead to medial coronoid disease.Methods: A prospective study of 14 Labrador Retrievers in their active growth stage was performed. The development of the antebrachia and elbow joints was assessed between six and 17 weeks of age using radio graphy and computed tomography determining the development of secondary ossification centres, radioulnar length ratio, radial angulation, and inter-relationship between the humerus, ulna and radius.Results: For the parameters of ossification of secondary ossification centres, radioulnar length ratio, radial angulation, and joint congruence evaluation, there was no significant difference in the development of the ante-brachia and elbow joints of seven Labrador Retrievers positive and seven Labrador Retrievers negative for MCD at the age of six to 17 weeks.Clinical significance: These findings demonstrate that the development of MCD in the Labrador Retrievers in our study was not related to any disturbance in the development of the antebrachia and elbow joints during the rapid growth phase.

scholarly journals T and N Staging of Gastric Cancer Using Dual-Source Computed Tomography

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Zhao-Yong Xie ◽  
Rui-Mei Chai ◽  
Guo-Cheng Ding ◽  
Yi Liu ◽  
Ke Ren
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Adipose Tissue ◽  
Iodine Concentration ◽  
Endoscopic Biopsy ◽  
Portal Phase ◽  
Significant Difference ◽  
Dual Source ◽  
N Staging ◽  
Dual Source Computed Tomography

Aim. This study is aimed at comparing gastric cancer T and N staging between virtual monochromatic energy images and fusion images generated by dual-source computed tomography (DSCT) dual-energy mode data acquisition prospectively while measuring the iodine concentration of gastric cancer and lymph nodes at different T and N stages from iodine map retrospectively. Methods. A total of 71 patients (50 males and 21 females; mean age: 59 ± 11 years) confirmed with gastric cancer by endoscopic biopsy with no neoadjuvant chemotherapy were enrolled for the CT examination before surgeries. The preoperative T and N staging results were compared between groups with pathological results as the gold standard. The iodine concentrations of the gastric lesions and LNs were measured on the iodine-based material decomposition images. All iodine concentration values were normalized against those in the abdominal aorta and defined as normalized iodine concentration (nIC) values. The short axis length of LNs and nIC values were statistically analyzed. Results. Group A was better than group B for T3 and T4 staging. No statistically significant difference in the overall accuracies for N staging was found between groups. For the late arterial and delayed phases, T3 and T4 nIC values of the extraserosal adipose tissue showed statistically significant differences. The nIC values between N0 and Nm (N1–N3) showed statistically significant differences in the portal phase only. Conclusions. T3 and T4 nIC values of the extraserosal adipose tissue showed statistically significant differences. Hence, dual-source CT may be helpful in the differential diagnosis between T3 and T4.

scholarly journals Prognosis of pulmonary fibrosis presenting with a usual interstitial pneumonia pattern on computed tomography in patients with myeloperoxidase anti-neutrophil cytoplasmic antibody-related nephritis: a retrospective single-center study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Toshikazu Watanabe ◽  
Tomoyuki Minezawa ◽  
Midori Hasegawa ◽  
Yasuhiro Goto ◽  
Takuya Okamura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Fibrosis ◽  
Interstitial Pneumonia ◽  
Lung Volume ◽  
Lung Fibrosis ◽  
Usual Interstitial Pneumonia ◽  
Three Dimensional ◽  
3D Ct ◽  
Antifibrotic Therapy ◽  
Significant Difference

Abstract Background Myeloperoxidase anti-neutrophil cytoplasmic antibody-related nephritis (MPO-ANCA nephritis) is occasionally accompanied by lung abnormalities such as pulmonary fibrosis. However, the clinical features of pulmonary fibrosis in patients with MPO-ANCA nephritis have not been well documented. This study was performed to compare the prognosis of a usual interstitial pneumonia (UIP) pattern of lung fibrosis in patients with MPO-ANCA nephritis with the prognosis of idiopathic pulmonary fibrosis (IPF). Methods We retrospectively reviewed the medical records of 126 patients with MPO-ANCA nephritis and identified 31 with a UIP pattern of lung fibrosis on high-resolution or thin-slice computed tomography (CT). We compared the characteristics and prognosis of these patients with those of 32 patients with IPF. In 18 patients from both groups, we assessed and compared the decline in lung volume over time using three-dimensional (3D) CT images reconstructed from thin-section CT data. Results The numbers of male and female patients were nearly equal among patients with MPO-ANCA nephritis exhibiting a UIP pattern; in contrast, significant male dominancy was observed among patients with IPF (p = 0.0021). Significantly fewer smokers were present among the patients with MPO-ANCA nephritis with a UIP pattern than among those with IPF (p = 0.0062). There was no significant difference in the median survival time between patients with MPO-ANCA nephritis with a UIP pattern (50.8 months) and IPF (55.8 months; p = 0.65). All patients with IPF in this cohort received antifibrotic therapy (pirfenidone or nintedanib). Almost half of the deaths that occurred in patients with MPO-ANCA nephritis with a UIP pattern were caused by non-respiratory-related events, whereas most deaths in patients with IPF were caused by respiratory failure such as acute exacerbation. In the 3D CT lung volume analyses, the rate of decline in lung volume was equivalent in both groups. Conclusions MPO-ANCA nephritis with a UIP pattern on CT may have an unfavorable prognosis equivalent to that of IPF with a UIP pattern treated with antifibrotic agents.

scholarly journals A study on maxillary sinus dimensions by computed tomography in population of Tamil Nadu

2016 ◽  
Vol 05 (02) ◽  
pp. 091-096
Author(s):  
N Muthukumaravel ◽  
K.Y Manjunath
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Tamil Nadu ◽  
Maximum Width ◽  
Average Width ◽  
Computed Tomographic ◽  
Significant Difference ◽  
The Difference ◽  
The Right ◽  
Maxillary Sinuses

Abstract Background and aims: Maxillary sinuses are the largest of the paranasal sinuses known for variability in their dimensions. The maxillary sinus dimensions can be better ascertained in living by using computed tomography instead of plain radiography. This study was planned for highlighting the variations in the dimensions of the maxillary sinuses of population of Tamil Nadu region. The aims of the present study were to estimate dimensions of the maxillary sinuses on computed tomographic (CT) scan of the head of patients from Tamil Nadu and to compare the data gender wise and sidewise. Material and methods: Maximum width, height and depth of maxillary sinus of both sides were measured in CT - head images of 100 males and 100 females of 20-50 years of age in Tamil Nadu. Comparison of data between genders and sides by applying unpaired student "t" test was done. Results : The mean depth, height and width of both right and left maxillary sinuses were comparatively less in females than the males and the difference was found to be statistically significant ( P <.0001). On comparison between the sides of maxillary sinuses, the depth and the height of maxillary sinus did not show any significant difference in the measurements (p >.05), whereas the width of the left side (23.96 mm) was higher than that of the right side (23.69) and the difference was found to be statistically significant (P<.05). The combined average maxillary sinus dimensions (in mm) for both genders in the study population of Tamil Nadu are as follows: Right side depth: 33.71 ± 1.00; Left side depth : 33.65 ± 1.22; Right side height: 34.66 ± 2.71; Left side height: 34.74± 2.48; Right side width: 23.69 ± 0.78 and Left side width: 23.96 ± 0.86. Conclusion: The dimensions of maxillary sinuses in males were found to be larger than those of females and this difference was statistically significant. The average width of the maxillary sinuses on the left side is significantly more than that of right sided sinuses. Computed tomography measurements of maxillary sinuses may be useful in gender determination.

Sign in / Sign up

Export Citation Format

Share Document