Clinical Research of Combined Application of DCEUS and Dynamic Contrast-Enhanced MSCT in Preoperative cT Staging of Gastric Cancer

Purpose. To investigate the clinical value of double contrast-enhanced ultrasound (DCEUS) combined with dynamic contrast-enhanced multislice CT (MSCT) in preoperative T staging of gastric cancer (GC). Methods. 206 patients with GC confirmed by preoperative gastroscopy from February 2019 to February 2021 were collected, all patients were examined by DCEUS and dynamic contrast-enhanced MSCT before operation, and the invasion depth (T staging) of GC was evaluated. The diagnosis results of DCEUS, dynamic contrast-enhanced MSCT, and combined diagnosis of DCEUS and MSCT methods (D&M method) were compared with the pathological staging results (gold standard). Results. The correct diagnosis rate of MSCT was 27.27% in T1 staging, 55.56% in T2 staging, 42.11% in T3 staging, 59.29% in T4 staging, and 55.34% in summation. The correct diagnosis rate of DCEUS was 90.91% in T1 staging, 88.89% in T2 staging, 78.95% in T3 staging, 82.86% in T4 staging, and 83.98% in summation. The correct diagnosis rate of the D&M method was 100.00% in T1 staging, 94.44% in T2 staging, 89.47% in T3 staging, 93.57% in T4 staging, and 93.69% in summation. The D&M method had higher correct diagnosis rate than MSCT or DCEUS alone, the correct diagnosis rate of the D&M method in T1, T2, T3, and T4 staging was significantly higher than that of MSCT ( P < 0.05 ). The correct diagnosis rate of the D&M method in T1, T3, and T4 was significantly higher than that of DCEUS ( P < 0.05 ). The Youden index of preoperative T1, T2, T3, and T4 staging of GC by the D&M method was 99.49%, 94.44%, 84.13%, and 90.54%, respectively, and the Kappa values of these were 0.954, 0.966, 0.707, and 0.881, respectively. Conclusions. Dynamic contrast-enhanced MSCT combined with DCEUS in the diagnosis of preoperative cT staging of GC has more validity, reliability, and revenue than the using of MSCT or DCEUS alone, which is an image evaluation method worthy of clinical promotion.

The Value of Chest CT in Staging of Gastric Cancer

Aims: Gastric cancer (GC) is one of the most common malignant tumors in the world. However, the significance of chest computed tomography (CT) in staging of GC is uncertain and the relevant study is few. So this study aims to evaluate the value of chest CT in gastric cancer staging.Methods: This study included 1158 cases of GC patients admitted to Shaoxing People's Hospital from 2015 to 2018. Chest, abdominal and pelvic CT scans were used to systematically evaluate the site of metastasis. All images were reviewed twice by two radiologists. Clinical data was Statistically analyzed.Results: The study finally included 846 patients, 672 cases (79.4%) received surgical treatment. Only 55 cases (6.5%) had lung metastases before or after surgery, and 20 cases (2.4%) had thoracic or supraclavicular lymph nodes (LN) metastases, of which 8 cases had double lung and thoracic LN metastases. The most common site of metastases is the peritoneum (265/390, 67.9%). Almost all lung or thoracic LN metastases accompanied with metastases to other sites, only one patient had a single thoracic LN metastases (1/846, 0.12%), while no single lung metastases was found. When tumor involved gastric fundus/cardia, compared to distal GC, there was a higher probability of lung metastases, and the difference was statistically significant (P=0.028).Conclusions: This study shows that chest CT has a low application value in the routine staging of gastric cancer, but when the tumor is located in the fundus/cardia, due to the high proportion of lung metastases, chest CT has a certain existence value.