Accuracy of whole-body diffusion-weighted MRI (WB-DWI/MRI) in diagnosis, staging and follow-up of gastric cancer, in comparison to CT: a pilot study

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Abstract

Background

Accurate staging of patients with gastric cancer is necessary for selection of the most appropriate and personalized therapy. Computed tomography (CT) is currently used as primary staging tool, being widely available with a relatively high accuracy for the detection of parenchymal metastases, but with low sensitivity for the detection of peritoneal metastases. Magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) has a very high contrast resolution, suggesting a higher diagnostic performance in the detection of small peritoneal lesions. The aim of this study was to retrospectively evaluate the added value of whole-body diffusion-weighted MRI (WB-DWI/MRI) to CT for detection of peritoneal carcinomatosis (PC) and distant metastases in the preoperative staging of gastric cancer.

Methods

This retrospective study included thirty-two patients with a suspicion of gastric cancer/recurrence, who underwent WB-DWI/MRI at 1.5 T, in addition to CT of thorax and abdomen. Images were evaluated by two experienced abdominal radiologists in consensus. Histopathology, laparoscopy and/or 1-year follow-up were used as reference standard.

Results

For overall tumour detection ( n = 32), CT sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) was 83.3%, 100%, 100% and 82.4% respectively. For WB-DWI/MRI these values were 100%, 92.9%, 94.7% and 100%, respectively. For staging ( n = 18) malignant lymph nodes and metastases, CT had a sensitivity, specificity/PPV/NPV of 50%/100%/100%/71.4%, and 15.4%/100%/100%/31.3% respectively. For WB-DWI/MRI, all values were 100%, for both malignant lymph nodes and metastases. WB-DWI/MRI was significantly better than CT in detecting tumour infiltration of the mesenteric root, serosal involvement of the small bowel and peritoneal metastases for which WB-DWI/MRI was correct in 100% of these cases, CT 0%.

Conclusions

WB-DWI/MRI is highly accurate for diagnosis, staging and follow-up of patients with suspected gastric cancer.

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Most cited references 36

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Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

Ahmedin Jemal, Lindsey A Torre, Rebecca Siegel … (2018)

This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.

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Ahmedin Jemal, Freddie Bray, Melissa M Center … (2011)

The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage at diagnosis and limited access to timely and standard treatment. A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination (for liver and cervical cancers), and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake. Clinicians, public health professionals, and policy makers can play an active role in accelerating the application of such interventions globally.

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E.C. Smyth, M Verheij, W Allum … (2016)

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Author and article information

Contributors

Sofie De Vuysere:

ORCID: http://orcid.org/0000-0001-5079-9015

sofie.devuysere@gmail.com

Journal

Journal ID (nlm-ta): BMC Med Imaging

Journal ID (iso-abbrev): BMC Med Imaging

Title: BMC Medical Imaging

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2342

Publication date (Electronic): 5 February 2021

Publication date PMC-release: 5 February 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 18

Affiliations

[1 ]GRID grid.5596.f, ISNI 0000 0001 0668 7884, Department of Radiology, University Hospitals Leuven, , KU Leuven, ; Herestraat 49, 3000 Leuven, Belgium

[2 ]GRID grid.414579.a, ISNI 0000 0004 0608 8744, Department of Radiology, , Imelda Hospital Bonheiden, ; Imeldalaan 9, 2820 Bonheiden, Belgium

[3 ]GRID grid.414579.a, ISNI 0000 0004 0608 8744, Department of Gastroenterology, , Imelda Hospital Bonheiden, ; Imeldalaan 9, 2820 Bonheiden, Belgium

[4 ]GRID grid.414579.a, ISNI 0000 0004 0608 8744, Department of Surgery, , Imelda Hospital Bonheiden, ; Imeldalaan 9, 2820 Bonheiden, Belgium

Author information

Sofie De Vuysere http://orcid.org/0000-0001-5079-9015

Article

Publisher ID: 550

DOI: 10.1186/s12880-021-00550-2

PMC ID: 7866710

PubMed ID: 33546626

SO-VID: 42f9aa5a-c887-49aa-b3c9-2ca6048c9956

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 21 October 2020

Date accepted : 19 January 2021

Custom metadata

ScienceOpen disciplines: Radiology & Imaging

Keywords: wb-dwi/mri,diffusion-weighted imaging (dwi),magnetic resonance imaging (mri),computed tomography (ct),stomach neoplasm,neoplasm metastases,neoplasm staging,peritoneal neoplasms

Data availability:

ScienceOpen disciplines: Radiology & Imaging

Keywords: wb-dwi/mri, diffusion-weighted imaging (dwi), magnetic resonance imaging (mri), computed tomography (ct), stomach neoplasm, neoplasm metastases, neoplasm staging, peritoneal neoplasms

Accuracy of whole-body diffusion-weighted MRI (WB-DWI/MRI) in diagnosis, staging and follow-up of gastric cancer, in comparison to CT: a pilot study

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Stroke MRI

Most cited references 36

Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

Global cancer statistics.

Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.

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