Value of multiphase contrast-enhanced CT with three-dimensional reconstruction in detecting depth of infiltration, lymph node metastasis, and extramural vascular invasion of gastric cancer

Abstract Background : The aim of our study was to determine whether tumor size measured by multidetector computed tomography (MDCT) could be used to evaluate lymph node metastasis (LNM) in patients with resectable colon cancer. Methods: This retrospective study consisted of 106 consecutive patients with colon cancer who underwent radical surgery within 1 week after contrast enhanced-CT scan. Tumor size including tumor length (Tlen), tumor maximum diameter (Tdia), t umor maximum cross-sectional area (Tare) and tumor volume (Tvol) were measured on contrast enhanced-CT images and correlated with pathologic LNM and N stages using univariate analysis, logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results: The inter - (intraclass correlation coefficient [ICC]=0.94, 0.81, 0.97, 0.99) and intraobserver (ICC=0.95, 0.93, 0.91 and 0.99) reproducibility of Tlen, Tdia, Tare and Tvol parameters measurement is excellent. Univariate analysis showed Tlen, Tdia, Tare, and Tvol could predict LNM (all P <0.05), whereas Tvol was an independent risk factor for LNM (odds ratio =1.09; 95% confidence interval, 1.02-1.17; P =0.017) by logistic regression analysis. Tlen, Tdia, Tare and Tvol could distinguish between N0 and N1, N0 and N2, N0 and N1-2, and N0-1 and N2 disease (all P < 0.05). The area under the ROC (AUC) was higher for Tvol than for Tlen, Tdia and Tare in identifying LNM (AUC =0.83, 0.82, 0.69, 0.79, respectively) and distinguishing N0 from N1 (AUC =0.79, 0.78, 0.63, 0.74, respectively), N0 from N2 (AUC =0.92, 0.89, 0.80, 0.89, respectively), and N0-1 from N2 (AUC =0.84, 0.79, 0.76, 0.83, respectively). Conclusion: Tlen , Tdia, Tare and Tvol measured with MDCT correlated with regional LNM in resectable colon cancer. In particular, Tvol showed the most potential for noninvasive preoperative evaluation of regional LNM.

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Clinical study of the diagnostic standards for cervical lymph node metastasis using contrast-enhanced CT

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/s0901-5027(97)80979-4 ◽

1997 ◽

Vol 26 ◽

pp. 45

Author(s):

H. Nakanishi ◽

E. Hayashi ◽

M. Nagayama ◽

A. Takahashi

Keyword(s):

Lymph Node ◽

Clinical Study ◽

Lymph Node Metastasis ◽

Cervical Lymph Node ◽

Cervical Lymph Node Metastasis ◽

Node Metastasis ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Diagnostic Standards

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Machine learning to identify lymph node metastasis from thyroid cancer in patients undergoing contrast-enhanced CT studies

Radiography ◽

10.1016/j.radi.2021.03.001 ◽

2021 ◽

Author(s):

T. Masuda ◽

T. Nakaura ◽

Y. Funama ◽

K. Sugino ◽

T. Sato ◽

...

Keyword(s):

Machine Learning ◽

Thyroid Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Node Metastasis ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Ct Studies

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Multi-factorial considerations for intra-thoracic lymph node evaluations of healthy cats on computed tomographic images

BMC Veterinary Research ◽

10.1186/s12917-021-02771-7 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Ninlawan Thammasiri ◽

Chutimon Thanaboonnipat ◽

Nan Choisunirachon ◽

Damri Darawiroj

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Ct Images ◽

Slice Thickness ◽

Maximum Width ◽

Post Contrast ◽

Computed Tomographic ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

Abstract Background It is difficult to examine mild to moderate feline intra-thoracic lymphadenopathy via and thoracic radiography. Despite previous information from computed tomographic (CT) images of intra-thoracic lymph nodes, some factors from animals and CT setting were less elucidated. Therefore, this study aimed to investigate the effect of internal factors from animals and external factors from the CT procedure on the feasibility to detect the intra-thoracic lymph nodes. Twenty-four, client-owned, clinically healthy cats were categorized into three groups according to age. They underwent pre- and post-contrast enhanced CT for whole thorax followed by inter-group evaluation and comparison of sternal, cranial mediastinal, and tracheobronchial lymph nodes. Results Post contrast-enhanced CT appearances revealed that intra-thoracic lymph nodes of kittens were invisible, whereas the sternal, cranial mediastinal, and tracheobronchial nodes of cats aged over 7 months old were detected (6/24, 9/24 and 7/24, respectively). Maximum width of these lymph nodes were 3.93 ± 0.74 mm, 4.02 ± 0.65 mm, and 3.51 ± 0.62 mm, respectively. By age, lymph node sizes of these cats were not significantly different. Transverse lymph node width of males was larger than that of females (P = 0.0425). Besides, the detection score of lymph nodes was affected by slice thickness (P < 0.01) and lymph node width (P = 0.0049). Furthermore, an irregular, soft tissue structure, possibly the thymus, was detected in all juvenile cats and three mature cats. Conclusions Despite additional information on intra-thoracic lymph nodes in CT images, which can be used to investigate lymphatic-related abnormalities, age, sex, and slice thickness of CT images must be also considered.

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CT diagnosis of ilioinguinal lymph node metastases in melanoma using radiological characteristics beyond size and asymmetry

BJS Open ◽

10.1093/bjsopen/zraa005 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

M J Wilkinson ◽

H Snow ◽

K Downey ◽

K Thomas ◽

A Riddell ◽

...

Keyword(s):

Lymph Node ◽

Diagnostic Accuracy ◽

Multivariable Analysis ◽

Ct Scans ◽

Non Invasive ◽

Poor Predictor ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Node Metastases

Abstract Background Diagnosis of lymph node (LN) metastasis in melanoma with non-invasive methods is challenging. The aim of this study was to evaluate the diagnostic accuracy of six LN characteristics on CT in detecting melanoma-positive ilioinguinal LN metastases, and to determine whether inguinal LN characteristics can predict pelvic LN involvement. Methods This was a single-centre retrospective study of patients with melanoma LN metastases at a tertiary cancer centre between 2008 and 2016. Patients who had preoperative contrast-enhanced CT assessment and ilioinguinal LN dissection were included. CT scans containing significant artefacts obscuring the pelvis were excluded. CT scans were reanalysed for six LN characteristics (extracapsular spread (ECS), minimum axis (MA), absence of fatty hilum (FH), asymmetrical cortical nodule (CAN), abnormal contrast enhancement (ACE) and rounded morphology (RM)) and compared with postoperative histopathological findings. Results A total of 90 patients were included. Median age was 58 (range 23–85) years. Eighty-eight patients (98 per cent) had pathology-positive inguinal disease and, of these, 45 (51 per cent) had concurrent pelvic disease. The most common CT characteristics found in pathology-positive inguinal LNs were MA greater than 10 mm (97 per cent), ACE (80 per cent), ECS (38 per cent) and absence of RM (38 per cent). In multivariable analysis, inguinal LN characteristics on CT indicative of pelvic disease were RM (odds ratio (OR) 3.3, 95 per cent c.i. 1.2 to 8.7) and ECS (OR 4.2, 1.6 to 11.3). Cloquet’s node is known to be a poor predictor of pelvic spread. Pelvic LN disease was present in 50 per cent patients, but only 7 per cent had a pathology-positive Cloquet’s node. Conclusion Additional CT radiological characteristics, especially ECS and RM, may improve diagnostic accuracy and aid clinical decisions regarding the need for inguinal or ilioinguinal dissection.

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