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Preoperative Evaluation of Lymph Node Metastases in Patients with Gastric Cancer: An Analysis of Imaging Methods

Günay, Yusuf | Çağlar, Emrah | Korkmaz, Esin | Erdemir, Rabiye Uslu | Taşdöven, İlhan | Kozan, Ramazan

Article | 2018 | ACTA ONCOLOGICA TURCICA51 ( 3 ) , pp.276 - 282

INTRODUCTION: Preoperative evaluation is necessary for the surgical treatment of gastric cancer (GC). Nonetheless, there is no single best diagnostic modality to predict lymph node metastases prior to surgery. The aim of this study was to analyze of the diagnostic utility of positron emission tomography-computed tomography (PET-CT) and CT for the preoperative evaluation of lymph node (LN) metastases in GC. METHODS: Eighty seven patients with a history of GC, who underwent gastrectomy and D2 LN dissection were investigated. Imaging test results and pathology reports were collected from the patients’ charts. RESULTS: There was no stat . . .istical differences between PET/CT and CT scans in regard to predicting LN metastases in GC patients (p>0.05). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT scans in predicting LN metastases were 55.56%, 54.55%, 55.26%, 75%, and 33.3%, respectively, versus 60.47%, 57.69%, 59.42%, 70.27%, and 46.88% for CT scans, respectively. However, combined PET/CT and CT showed better outcomes and specificity with a PPV of 80% and 88.9%, respectively. No patients or tumor factors were found to increase the accuracy of LN metastasis prediction using either PET/CT or CT scans. DISCUSSION AND CONCLUSION: The combination of CT and PET/CT scans increases the specificity and PPV. This increases the prediction accuracy of LN metastasis in GC patients compared to the use of each type of imaging modality alone. INTRODUCTION: Preoperative evaluation is necessary for the surgical treatment of gastric cancer (GC). Nonetheless, there is no single best diagnostic modality to predict lymph node metastases prior to surgery. The aim of this study was to analyze of the diagnostic utility of positron emission tomography-computed tomography (PET-CT) and CT for the preoperative evaluation of lymph node (LN) metastases in GC. METHODS: Eighty seven patients with a history of GC, who underwent gastrectomy and D2 LN dissection were investigated. Imaging test results and pathology reports were collected from the patients’ charts. RESULTS: There was no statistical differences between PET/CT and CT scans in regard to predicting LN metastases in GC patients (p>0.05). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT scans in predicting LN metastases were 55.56%, 54.55%, 55.26%, 75%, and 33.3%, respectively, versus 60.47%, 57.69%, 59.42%, 70.27%, and 46.88% for CT scans, respectively. However, combined PET/CT and CT showed better outcomes and specificity with a PPV of 80% and 88.9%, respectively. No patients or tumor factors were found to increase the accuracy of LN metastasis prediction using either PET/CT or CT scans. DISCUSSION AND CONCLUSION: The combination of CT and PET/CT scans increases the specificity and PPV. This increases the prediction accuracy of LN metastasis in GC patients compared to the use of each type of imaging modality alone Daha fazlası Daha az

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