Prospective comparison of 3T MRI with diffusion-weighted imaging and MDCT for the preoperative TNM staging of gastric cancer.
PURPOSE
To compare the diagnostic performance of 3T magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) and multidetector-row computed tomography (MDCT) for the preoperative TNM staging of gastric cancer.


MATERIALS AND METHODS
This prospective study was approved by our Institutional Review Board. Forty-nine consecutive patients with histologically confirmed gastric cancers underwent MDCT and 3T MRI followed by surgery. MRI without DWI, MRI with DWI, and MDCT were reviewed to determine preoperative TNM staging. Using the pathologic stages as the reference standard, the diagnostic performance of each imaging modality was compared.


RESULTS
Diagnostic accuracies of MRI with DWI, MRI without DWI, and MDCT did not show a significant difference (≤T2 vs. ≥T3: 85.1%, 78.7%, and 80.9%; ≤T3 vs. T4: 76.6%, 74.5%, and 72.3%; N-negative vs. N-positive: 76.6%, 66.0%, and 63.8%; M0 vs. M1: all 95.9%, respectively) (P > 0.05). For N staging, MRI with DWI demonstrated higher sensitivity but lower specificity (86.7% and 58.8%, respectively) than MRI without DWI (50.0% and 94.1%) or MDCT (43.3% and 100%) (P < 0.05).


CONCLUSION
The diagnostic accuracy of 3T MRI is comparable to that of MDCT for the preoperative TNM staging of gastric cancer, and for assessing LN metastasis, the addition of DWI to conventional MRI may increase the sensitivity.
['Joo|Ijin|I|', 'Lee|Jeong Min|JM|', 'Kim|Jung Hoon|JH|', 'Shin|Cheong-Il|CI|', 'Han|Joon Koo|JK|', 'Choi|Byung Ihn|BI|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D003287:Contrast Media D038524:Diffusion Magnetic Resonance Imaging D005260:Female D006801:Humans D007089:Image Enhancement D008297:Male D008875:Middle Aged D061330:Multidetector Computed Tomography D009367:Neoplasm Staging D011300:Preoperative Care D011446:Prospective Studies D015203:Reproducibility of Results D012680:Sensitivity and Specificity D013270:Stomach D013274:Stomach Neoplasms
MRI MDCT staging gastric cancer