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He H, Tang T, Wang X, Zhou L, Wang L. Comparing endoscopic ultrasonography and double contrast-enhanced ultrasonography in the preoperative diagnosis of gastric stromal tumor. Cancer Imaging 2023; 23:122. [PMID: 38102702 PMCID: PMC10724945 DOI: 10.1186/s40644-023-00646-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND This study was designed to perform a comparative analysis between endoscopic ultrasonography (EUS) and double contrast-enhanced ultrasonography (DCEUS) for the preoperative diagnosis of gastric stromal tumors (GSTs). METHODS A retrospective study was conducted involving 139 patients with histologically confirmed GSTs. All patients preoperatively underwent DCEUS and EUS. The pathology reports were treated as the baseline and were retrospectively compared with the findings of EUS and DCEUS. RESULTS Of the 139 lesions, 120 and 113 were correctly identified by DCEUS and EUS, respectively, with an accuracy of 86.3% and 81.3%. The results revealed an insignificant difference between these two methods (p = 0.189). CONCLUSIONS DCEUS can display not only the locations, sizes, shapes, borders, internal echoes, but also show the blood perfusion patterns of GSTs. It is a highly accurate, noninvasive, and convenient method to be used at the pre-treatment stage.
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Affiliation(s)
- Huiliao He
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Tingting Tang
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Xiaohua Wang
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Lingling Zhou
- Department of Pathology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Liang Wang
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China.
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2
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Gastric adenocarcinoma: A review of the TNM classification system and ways of spreading. RADIOLOGIA 2023; 65:66-80. [PMID: 36842787 DOI: 10.1016/j.rxeng.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/12/2022] [Indexed: 02/28/2023]
Abstract
Gastric cancer is the fifth most common cancer in the world. The most common histologic subtype is adenocarcinoma. Gastric adenocarcinomas are staged using the American Joint Committee on Cancer's 8th TNM classification. The perigastric ligaments, mesentery, omentum, and potential spaces between the parietal and visceral peritoneal linings play are important structures for staging. The spread of disease is influenced by the location of the tumor within the stomach, as well as by the anatomy related to the ligaments and lymph vessels. CT is the imaging modality of choice for the preoperative clinical staging of gastric cancer, and it is essential for planning treatment. To be able to do an adequate imaging workup, radiologists need to know the different pathways through which gastric cancer can spread: lymphatic, subperitoneal, direct invasion, transperitoneal, hematogenous, and extramural venous invasion.
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3
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Adenocarcinoma gástrico: revisión del TNM y de las vías de diseminación. RADIOLOGIA 2022. [DOI: 10.1016/j.rx.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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4
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Malla S, Kumar P, Madhusudhan KS. Radiology of the neuroendocrine neoplasms of the gastrointestinal tract: a comprehensive review. Abdom Radiol (NY) 2021; 46:919-935. [PMID: 32960304 DOI: 10.1007/s00261-020-02773-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 02/08/2023]
Abstract
Neuroendocrine neoplasms (NENs) are a group of neoplasms arising from the diffuse endocrine system (DES). The gastrointestinal tract (GIT) is the most common site of NEN. The WHO classification divides NEN into three broad categories viz. well-differentiated NENs, poorly differentiated NENs, and mixed neuroendocrine-non-neuroendocrine neoplasms. All GIT NEN have the potential to synthesize and secrete various bioactive substances which may lead to various clinical syndromes. The NEN may occur anywhere in the GIT and exhibit varying clinical presentation, prognosis, and metastatic potential. Further, some tumors show association with familial syndromes like multiple endocrine neoplasia type 1 and neurofibromatosis type 1. Ultrasonography, computed tomography (CT), magnetic resonance imaging, and positron emission tomography-CT are the imaging modalities useful in the diagnosis, localization, and staging of GIT NEN. Management depends on the site, size, grade, and stage of the tumor with interventional radiology playing a significant role in some cases. This imaging review describes the role of a radiologist in the management of GIT NEN.
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Affiliation(s)
- Sundeep Malla
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Pawan Kumar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
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5
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Gut wrenching: cases of missed gastrointestinal tumors and their mimics on computed tomography. Emerg Radiol 2020; 28:389-399. [PMID: 33025217 DOI: 10.1007/s10140-020-01832-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
Abstract
Computed tomography (CT) of the abdomen and pelvis is one of the most common imaging studies ordered through the emergency department (ED). Because these studies are ordered for the detection of acute abnormalities and due to the relatively low incidence in patients presenting through the ED, gastrointestinal tumors are commonly missed. Moreover, many CT findings of malignant tumors overlap with benign entities, which can present a diagnostic challenge. This review article will describe the common CT findings of gastric, small bowel, colon, and appendiceal cancer as well as some of the common benign gastrointestinal conditions with similar imaging findings.
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6
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Wani AH, Parry AH, Feroz I, Choh NA. Preoperative Staging of Gastric Cancer Using Computed Tomography and Its Correlation with Histopathology with Emphasis on Multi-planar Reformations and Virtual Gastroscopy. J Gastrointest Cancer 2020; 52:606-615. [PMID: 32535756 DOI: 10.1007/s12029-020-00436-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gastric cancer is the fifth most common cancer in the world. Preoperative staging of gastric cancer has assumed pivotal role in deciding appropriate management of gastric cancer with multi-detector computed tomography (MDCT) using hydro- and gaseous distension of stomach superseding endoscopic ultrasound in tumor (T) and nodal (N) staging. We undertook this study to evaluate the diagnostic accuracy of MDCT in the T and N staging of gastric cancer with an attempt to differentiate between early and advanced gastric carcinomas. METHODS A total of 160 patients with endoscopically diagnosed and biopsy-proven gastric cancer were subjected to MDCT after adequate gaseous and hydro-distention of stomach. Multi-planar reformatted (MPR) as well as virtual gastroscopy images were also obtained. Gastric lesions were categorized into T1 to T4 stages with N staging from N0 to N3. Preoperative CT findings were correlated with histopathological findings. RESULTS Overall diagnostic accuracy of T staging in our study was 82.5% (132/160) with an accuracy of 75% (120/160) for N staging. The diagnostic accuracy of CT for early gastric carcinoma in our study was 93.75% with high specificity of 96% but low sensitivity of 66.7%. CONCLUSION MDCT using gaseous and hydro-distension of stomach is an excellent modality for near accurate preoperative T staging of gastric cancer. However, CT has a limited role in the N staging of gastric cancer. This study also suggested that the combined use of virtual gastroscopy and MPR images helps in better detection of early gastric cancers.
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Affiliation(s)
- Abdul Haseeb Wani
- Department of Radiodiagnosis, Sher-i-Kashmir Institute of Medical Sciences, Soura Srinagar, Jammu & Kashmir, 190011, India.
| | - Arshed Hussain Parry
- Department of Radiodiagnosis, Sher-i-Kashmir Institute of Medical Sciences, Soura Srinagar, Jammu & Kashmir, 190011, India
| | - Imza Feroz
- Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, Soura Srinagar, Jammu & Kashmir, 190011, India
| | - Naseer Ahmad Choh
- Department of Radiodiagnosis, Sher-i-Kashmir Institute of Medical Sciences, Soura Srinagar, Jammu & Kashmir, 190011, India
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7
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Anderson AC, Millet JD, Manganaro MS, Wasnik AP. Multimodality Imaging of Gastric Pathologic Conditions: A Primer for Radiologists. Radiographics 2020; 40:707-708. [PMID: 32364884 DOI: 10.1148/rg.2020190065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Ashley C Anderson
- From the Department of Radiology, Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1D502, Ann Arbor, MI 48109-5030
| | - John D Millet
- From the Department of Radiology, Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1D502, Ann Arbor, MI 48109-5030
| | - Matthew S Manganaro
- From the Department of Radiology, Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1D502, Ann Arbor, MI 48109-5030
| | - Ashish P Wasnik
- From the Department of Radiology, Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, B1D502, Ann Arbor, MI 48109-5030
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Young JJ, Pahwa A, Patel M, Jude CM, Nguyen M, Deshmukh M, Huang L, Mohammad SF. Ligaments and Lymphatic Pathways in Gastric Adenocarcinoma. Radiographics 2019; 39:668-689. [DOI: 10.1148/rg.2019180113] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Jennifer J. Young
- From the Department of Radiological Sciences (J.J.Y., M.P.) and Division of Digestive Diseases (L.H.), University of California Los Angeles, Ronald Reagan UCLA Medical Center, Los Angeles, Calif; and Department of Radiological Sciences, Olive View–UCLA Medical Center, 14445 Olive View Dr, Sylmar, CA 91342 (A.P., C.M.J., M.N., M.D., S.F.M.)
| | - Anokh Pahwa
- From the Department of Radiological Sciences (J.J.Y., M.P.) and Division of Digestive Diseases (L.H.), University of California Los Angeles, Ronald Reagan UCLA Medical Center, Los Angeles, Calif; and Department of Radiological Sciences, Olive View–UCLA Medical Center, 14445 Olive View Dr, Sylmar, CA 91342 (A.P., C.M.J., M.N., M.D., S.F.M.)
| | - Maitraya Patel
- From the Department of Radiological Sciences (J.J.Y., M.P.) and Division of Digestive Diseases (L.H.), University of California Los Angeles, Ronald Reagan UCLA Medical Center, Los Angeles, Calif; and Department of Radiological Sciences, Olive View–UCLA Medical Center, 14445 Olive View Dr, Sylmar, CA 91342 (A.P., C.M.J., M.N., M.D., S.F.M.)
| | - Cecilia M. Jude
- From the Department of Radiological Sciences (J.J.Y., M.P.) and Division of Digestive Diseases (L.H.), University of California Los Angeles, Ronald Reagan UCLA Medical Center, Los Angeles, Calif; and Department of Radiological Sciences, Olive View–UCLA Medical Center, 14445 Olive View Dr, Sylmar, CA 91342 (A.P., C.M.J., M.N., M.D., S.F.M.)
| | - Michael Nguyen
- From the Department of Radiological Sciences (J.J.Y., M.P.) and Division of Digestive Diseases (L.H.), University of California Los Angeles, Ronald Reagan UCLA Medical Center, Los Angeles, Calif; and Department of Radiological Sciences, Olive View–UCLA Medical Center, 14445 Olive View Dr, Sylmar, CA 91342 (A.P., C.M.J., M.N., M.D., S.F.M.)
| | - Monica Deshmukh
- From the Department of Radiological Sciences (J.J.Y., M.P.) and Division of Digestive Diseases (L.H.), University of California Los Angeles, Ronald Reagan UCLA Medical Center, Los Angeles, Calif; and Department of Radiological Sciences, Olive View–UCLA Medical Center, 14445 Olive View Dr, Sylmar, CA 91342 (A.P., C.M.J., M.N., M.D., S.F.M.)
| | - Lizhou Huang
- From the Department of Radiological Sciences (J.J.Y., M.P.) and Division of Digestive Diseases (L.H.), University of California Los Angeles, Ronald Reagan UCLA Medical Center, Los Angeles, Calif; and Department of Radiological Sciences, Olive View–UCLA Medical Center, 14445 Olive View Dr, Sylmar, CA 91342 (A.P., C.M.J., M.N., M.D., S.F.M.)
| | - Shaden F. Mohammad
- From the Department of Radiological Sciences (J.J.Y., M.P.) and Division of Digestive Diseases (L.H.), University of California Los Angeles, Ronald Reagan UCLA Medical Center, Los Angeles, Calif; and Department of Radiological Sciences, Olive View–UCLA Medical Center, 14445 Olive View Dr, Sylmar, CA 91342 (A.P., C.M.J., M.N., M.D., S.F.M.)
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Wang W, Cao K, Han Y, Zhu X, Ding J, Peng W. Computed tomographic characteristics of gastric schwannoma. J Int Med Res 2019; 47:1975-1986. [PMID: 30871392 PMCID: PMC6567782 DOI: 10.1177/0300060519833539] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective This study aimed to characterize the computed tomographic (CT) features of gastric schwannoma (GS). Methods We retrospectively reviewed CT images of 19 cases of histologically proven GS between January 2010 and December 2015. Tumor location, size, contour, margin, growth pattern, and degree and pattern of enhancement, perigastric lymph nodes, ulceration, necrosis, and calcification were evaluated. Results GS was located in the gastric body (73.7%), gastric antrum (15.8%), and gastric fundus (10.5%), with a mean maximum diameter of 4.5 ± 1.8 cm. All tumors presented as oval, well-defined solid masses, with exophytic (36.8%), endoluminal (15.8%), or mixed (47.4%) growth patterns. Ulcers (57.9%) and perigastric lymph nodes (47.4%) were observed. Moderate enhancement (87.5%) was observed in the portal phase. Eighteen (94.7%) cases showed homogeneous enhancement. Conclusions GS typically presents as a mass in the stomach with an exophytic or mixed growth pattern, moderate homogeneous enhancement, and is prone to be accompanied by perigastric lymph node inflammatory reactive swelling. Larger GSs are more likely to be associated with ulcers.
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Affiliation(s)
- Wei Wang
- 1 Department of Radiology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai, PR China.,2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Kaiming Cao
- 3 Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Yang Han
- 4 Department of Pathology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Xiaoli Zhu
- 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.,5 Department of Pathology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai, PR China
| | - Jianhui Ding
- 1 Department of Radiology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai, PR China.,2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Weijun Peng
- 1 Department of Radiology, Fudan University Shanghai Cancer Center (FUSCC), Shanghai, PR China.,2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China
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10
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Tanaka T, Akiyoshi H, Mie K, Okamoto M, Yoshida Y, Kurokawa S. Contrast-enhanced computed tomography may be helpful for characterizing and staging canine gastric tumors. Vet Radiol Ultrasound 2018; 60:7-18. [PMID: 30123960 DOI: 10.1111/vru.12677] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/04/2018] [Accepted: 06/04/2018] [Indexed: 02/06/2023] Open
Abstract
In humans, computed tomography (CT) is a widely performed technique for the diagnosis and staging of gastric tumors. The purpose of this retrospective case series study was to describe CT findings in a group of dogs with confirmed gastric tumors. For each included dog, the following CT parameters were recorded: gastric tumor location, tumor shape, gastric involvement pattern, tumor enhancement pattern in early and late phases, presence and location of lymphadenopathy, gastric tumor attenuation values, attenuation values of enlarged lymph nodes, maximum short-axis diameter (mm) of enlarged lymph node, maximum long-axis diameter (mm) of enlarged lymph node, and short-axis diameter to long-axis diameter ratio (short axis/long axis). A total of 16 dogs met inclusion criteria and had the following final diagnoses: five lymphoma, six adenocarcinoma, three inflammatory polyps, and two leiomyoma. In the early- and delayed-phase postcontrast images, the mean CT attenuation value for lymphoma was lower than that of other gastric tumors. Lymphadenopathy was widespread in lymphomas and regional in adenocarcinomas. Lymphadenopathy was not detected in leiomyomas. Lymph node measurements in lymphoma were larger than lymph node measurements in adenocarcinoma. Although there were overlapping findings for the different types of gastric tumors, contrast-enhanced CT provided helpful information for characterizing gastric tumors based on the following criteria: early and late enhancement patterns, the site of origin of the mass lesion, and extent of local invasion and distant metastases. Lymphoma should be considered for canine gastric tumors with low mean attenuation values during early- and delayed-phase postcontrast images, and widespread, bulky, and rounded lymphadenopathy.
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Affiliation(s)
- Toshiyuki Tanaka
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan.,Kinki Animal Medical Training Institute & Veterinary Clinic, Higashiosaka, Osaka, 578-0984, Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan
| | - Keiichiro Mie
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan
| | - Mari Okamoto
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan
| | - Yuuki Yoshida
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan
| | - Shohei Kurokawa
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan
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11
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CT textural analysis of gastric cancer: correlations with immunohistochemical biomarkers. Sci Rep 2018; 8:11844. [PMID: 30087428 PMCID: PMC6081398 DOI: 10.1038/s41598-018-30352-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/27/2018] [Indexed: 02/06/2023] Open
Abstract
To investigate the ability of CT texture analysis to assess and predict the expression statuses of E-cadherin, Ki67, VEGFR2 and EGFR in gastric cancers, the enhanced CT images of 139 patients with gastric cancer were retrospectively reviewed. The region of interest was manually drawn along the margin of the lesion on the largest slice in the arterial and venous phases, which yielded a series of texture parameters. Our results showed that the standard deviation, width, entropy, entropy (H), correlation and contrast from the arterial and venous phases were significantly correlated with the E-cadherin expression level in gastric cancers (all P < 0.05). The skewness from the arterial phase and the mean and autocorrelation from the venous phase were negatively correlated with the Ki67 expression level in gastric cancers (all P < 0.05). The width, entropy and contrast from the venous phase were positively correlated with the VEGFR2 expression level in gastric cancers (all P < 0.05). No significant correlation was found between the texture features and EGFR expression level. CT texture analysis, which had areas under the receiver operating characteristic curve (AUCs) ranging from 0.612 to 0.715, holds promise in predicting E-cadherin, Ki67 and VEGFR2 expression levels in gastric cancers.
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12
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Patel M, Jilani D, Oto A, Patel P. Evaluating the Sensitivity of Arterial Phase CT Images for Detection of Hepatic GIST Metastases. Tomography 2018; 3:101-104. [PMID: 30042975 PMCID: PMC6024457 DOI: 10.18383/j.tom.2017.00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Gastrointestinal stromal tumor (GIST) frequently metastasizes to the liver, and conventional staging computed tomography (CT) protocols use multiphasic contrast enhancement for detection of hepatic lesions. We evaluated the sensitivity of arterial phase CT imaging for hepatic GIST metastases compared with that of standard (portal venous [PV]) phase imaging. We conducted a retrospective review of patients who presented with hepatic GIST metastases identified on staging CT examinations between 2005 and 2015. Arterial and PV phase CT images were randomized and reviewed by 2 radiologists blinded to clinical history, correlative imaging, and number of controls. In total, 32 patients had hepatic metastases identified on multiphasic (arterial and PV) staging CT examinations. There was no significant difference in identification of metastases between arterial and PV phase imaging (31 vs 32, P = .32). Lesion size measurements did not significantly differ (P = .58). Arterial phase CT imaging did not significantly increase the sensitivity for hepatic GIST metastases compared with PV phase imaging alone.
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Affiliation(s)
- Mikin Patel
- Department of Radiology, The University of Chicago Medicine, Chicago, Illinois
| | - Danial Jilani
- Department of Radiology, The University of Chicago Medicine, Chicago, Illinois
| | - Aytekin Oto
- Department of Radiology, The University of Chicago Medicine, Chicago, Illinois
| | - Pritesh Patel
- Department of Radiology, The University of Chicago Medicine, Chicago, Illinois
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13
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Wang P, Zhang CZ, Wang GB, Li YY, Jiang XY, Fang FJ, Li XX, Bian J, Cao XS, Zhong XF. Evaluation of computed tomography vascular reconstruction for the localization diagnosis of perigastric mass. Medicine (Baltimore) 2018; 97:e11177. [PMID: 29952968 PMCID: PMC6039609 DOI: 10.1097/md.0000000000011177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the utility of computed tomography (CT) vascular reconstruction in the localization diagnosis of perigastric mass. METHODS Fifty-eight patients with pathologically detected perigastric mass underwent abdominal dynamic contrast-enhanced CT. CT vascular reconstructions were produced from arterial phase data using volume rendering (VR), multiplanar reconstruction (MPR), and maximal intensity projection (MIP). Image analysis was focused on the relationship between the mass, perigastric arteries, and the gastric wall. Localization diagnosis values were compared between CT vascular reconstruction and dynamic-enhanced CT images. RESULTS Among the 58 cases of perigastric mass, 41 cases originated from the stomach, 7 cases from the left liver lobe, 6 from the pancreas, 2 from lessor omental bursa, 1 from transverse mesocolon, and 1 from left adrenal gland. The accuracy of CT vascular reconstruction images in the localization diagnosis of perigastric mass was higher than that of dynamic-enhanced CT images (98.3% and 86.2%, respectively, P = .04). On the reference level, 35 (35/41) patients with stomach-originated masses showed the mass adjacent perigastric arteries pushed away from the stomach (arterial displacement sign), and 15 (15/17) patients with nonstomach-originated masses showed perigastric arteries between the mass and the stomach (arterial entrapment sign). The sensitivity, specificity, positive predictive value, and negative predictive value of the localization diagnosis of perigastric mass with arterial displacement sign were 85.4%, 100%, 100%, and 73.9%, respectively, and with arterial entrapment sign, 88.2%, 100%, 100%, and 95.3%, respectively. CONCLUSION CT vascular reconstruction can clearly depict the relationship between perigastric mass and adjacent perigastric arteries, which may help us more accurately differentiate between stomach-originated and nonstomach-originated masses compared with original dynamic-enhanced CT images.
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Affiliation(s)
- Ping Wang
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University
| | - Cheng-Zhou Zhang
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University
| | - Guang-Bin Wang
- Shandong Medical Imaging Research Institute, Shandong University
| | - Yang-Yang Li
- Department of Pathology, The Affiliated Hospital of Binzhou Medical University, Shandong, P. R. China
| | - Xing-Yue Jiang
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University
| | - Fang-Jun Fang
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University
| | - Xiao-Xiao Li
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University
| | - Jia Bian
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University
| | - Xin-Shan Cao
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University
| | - Xiao-Fei Zhong
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University
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14
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Liu S, Shi H, Ji C, Zheng H, Pan X, Guan W, Chen L, Sun Y, Tang L, Guan Y, Li W, Ge Y, He J, Liu S, Zhou Z. Preoperative CT texture analysis of gastric cancer: correlations with postoperative TNM staging. Clin Radiol 2018; 73:756.e1-756.e9. [PMID: 29625746 DOI: 10.1016/j.crad.2018.03.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/08/2018] [Indexed: 02/07/2023]
Abstract
AIM To explore the role of computed tomography (CT) texture analysis in predicting pathologic stage of gastric cancers. MATERIALS AND METHODS Preoperative enhanced CT images of 153 patients (112 men, 41 women) with gastric cancers were reviewed retrospectively. Regions of interest (ROIs) were manually drawn along the margin of the lesion on the section where it appeared largest on the arterial and venous CT images, which yielded texture parameters, including mean, maximum frequency, mode, skewness, kurtosis, and entropy. Correlations between texture parameters and pathological stage were analysed with Spearman's correlation test. The diagnostic performance of CT texture parameters in differentiating different stages was evaluated using receiver operating characteristic (ROC) analysis. RESULTS Maximum frequency in the arterial phase and mean, maximum frequency, mode in the venous phase correlated positively with T stage, N stage, and overall stage (all p<0.05) of gastric cancer. Entropy in the venous phase also correlated positively with N stage (p=0.009) and overall stage (p=0.032). Skewness in the arterial phase had the highest area under the ROC curve (AUC) of 0.822 in identifying early from advanced gastric cancers. Multivariate analysis identified four parameters, including maximum frequency, skewness, entropy in the venous phase, and differentiation degree from biopsy, for predicting lymph node metastasis of gastric cancer. The multivariate model could distinguish gastric cancers with and without lymph node metastasis with an AUC of 0.892. CONCLUSION Multiple CT texture parameters, especially those in the venous phase, correlated well with pathological stage and hold great potential in predicting lymph node metastasis of gastric cancers.
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Affiliation(s)
- S Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - H Shi
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - C Ji
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - H Zheng
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - X Pan
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - W Guan
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - L Chen
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Y Sun
- Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - L Tang
- Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Y Guan
- School of Electronic Science and Engineering, Nanjing University, Nanjing, 210046, China
| | - W Li
- School of Electronic Science and Engineering, Nanjing University, Nanjing, 210046, China
| | - Y Ge
- School of Electronic Science and Engineering, Nanjing University, Nanjing, 210046, China
| | - J He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - S Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Z Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
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Zhang W, Chen T, Zhang M, Liu P, Lu Z. [A radiomics-based model for differentiation between benign and malignant gastrointestinal stromal tumors]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:55-61. [PMID: 33177032 DOI: 10.3969/j.issn.1673-4254.2018.01.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To establish a model for discrimination between benign and malignant gastrointestinal stromal tumors (GIST) by analyzing the texture features extracted from computed tomography (CT) images. METHODS The CT datasets were collected from 110 patients with GIST (including 80 as the training cohort and 30 as the validation cohort). Feature set reduction was executed with the 0.632 + bootstrap method in the initial feature set followed by stepwise forward feature selection in the feature subset, and the classification model was generated by logistic regression. RESULTS The 6-texture-featurebased classification model successfully discriminated between benign and malignant GIST in both the training and validation cohorts with AUCs of 0.93 and 0.91, sensitivity of 0.88 and 0.87, specificity of 0.85 and 0.86, and accuracy of 0.87 and 0.86 in the two cohorts, respectively. CONCLUSIONS This classification model established by radiomics analysis is capable of discrimination between benign and malignant GIST to provide assistance in preoperative diagnosis of GIST.
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Affiliation(s)
- Wenhua Zhang
- Key Laboratory for Medical Imaging, Southern Medical University, Southern Medical University, Guangzhou 510515, China
| | - Tao Chen
- Department of General Surgery, Nanfang Hospital, Guangdong Provincial Engineering Technology Research Center of Minimally Invasive Surgery, Southern Medical University, Guangzhou 510515, China
| | - Minghui Zhang
- Key Laboratory for Medical Imaging, Southern Medical University, Southern Medical University, Guangzhou 510515, China
| | - Pingping Liu
- Key Laboratory for Medical Imaging, Southern Medical University, Southern Medical University, Guangzhou 510515, China
| | - Zhentai Lu
- Key Laboratory for Medical Imaging, Southern Medical University, Southern Medical University, Guangzhou 510515, China
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Tsurumaru D, Miyasaka M, Muraki T, Nishie A, Asayama Y, Oki E, Oda Y, Honda H. Histopathologic diversity of gastric cancers: Relationship between enhancement pattern on dynamic contrast-enhanced CT and histological type. Eur J Radiol 2017; 97:90-95. [PMID: 29153374 DOI: 10.1016/j.ejrad.2017.10.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/23/2017] [Accepted: 10/24/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate the diagnostic value of contrast-enhanced computed tomography gastrography (CE-CTG) to predict the histological type of gastric cancer. MATERIALS AND METHODS We analyzed 47 consecutive patients with resectable advanced gastric cancer preoperatively evaluated by multiphasic dynamic contrast-enhanced CT. Two radiologists independently reviewed the CT images and they determined the peak enhancement phase, and then measured the CT attenuation value of the gastric lesion for each phase. The histological types of gastric cancers were assigned to three groups as differentiated-type, undifferentiated-type, and mixed-type. We compared the peak enhancement phase of the three types and compared the CT attenuation values in each phase. RESULTS The peak enhancement was significantly different between the three types of gastric cancers for both readers (reader 1, p=0.001; reader 2, p=0.009); most of the undifferentiated types had peak enhancement in the delayed phase. The CT attenuation values of undifferentiated type were significantly higher than those of differentiated or mixed type in the delayed phase according to both readers (reader 1, p=0.002; reader 2, p=0.004). CONCLUSION CE-CTG could provide helpful information in diagnosing the histological type of gastric cancers preoperatively.
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Affiliation(s)
- Daisuke Tsurumaru
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan.
| | - Mitsutoshi Miyasaka
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan.
| | - Toshio Muraki
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan.
| | - Akihiro Nishie
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan.
| | - Yoshiki Asayama
- Department of Advanced Imaging and Interventional Radiology, Graduate School of Medical Sciences, Kyushu University, Japan.
| | - Eiji Oki
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Japan.
| | - Yoshinao Oda
- Department of Anatomic Pathology and Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Japan.
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan.
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Li T, Lu M, Song J, Wu P, Cheng X, Zhang Z. Improvement to ultrasonographical differential diagnosis of gastric lesions: The value of contrast enhanced sonography with gastric distention. PLoS One 2017; 12:e0182332. [PMID: 28783738 PMCID: PMC5544423 DOI: 10.1371/journal.pone.0182332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/17/2017] [Indexed: 01/17/2023] Open
Abstract
Objective The purpose of this retrospective study is to evaluate the diagnostic value of contrast enhanced sonography plus gastric distention sonography, the Double Contrast-enhanced Ultrasound (DCUS) in gastric lesions. Methods 107 cases with pathology confirmed gastric lesions were retrospectively reviewed, DCUS and oral contrast agent ultrasound (US) were performed in all cases prior to operation. Perfusion parameters including arrival time (AT), peak intensity (PI), time to peak (TTP), and area under the curve (AUC) of the lesion and surrounding normal tissue were analyzed. A reader blinded to pathology results were asked to rate and compare each case with surgical or resection biopsy pathology results. Results From the 107 gastric lesions, 75 were malignant gastric lesions (33 gastric cancers,42 gastrointestinal stromal tumors (GISTs)) and 32 were benign gastric lesions (11 inflammatory masses and 21 polypoid adenomas). Compared with US, DCUS achieved higher value in sensitivity (90.6% vs. 70.6%), specificity (75% vs. 62.5%), positive predictive value (89.5% vs. 81.5%), negative predictive value (77.4% vs. 47.6%), and overall accuracy (85.9% vs. 68.2%). When US was tested against DCUS, the increase in correct diagnoses value was significant (P = .01). Furthermore, gastric cancer had faster AT, higher PI and AUC than normal tissue (P<0.05); GIST and Inflammatory mass had higher PI than normal tissue (P<0.05); gastric cancer and GIST had faster AT than polypoid adenoma (P<0.05), Inflammatory mass showed higher PI than other 3 lesions and gastric cancer had higher PI than polypoid adenoma and GIST (P<0.05); gastric cancer and inflammatory mass had larger AUC than polypoid adenoma and GIST (P<0.05). Conclusion DCUS improved diagnostic performance compared with US. The combination of different CEUS enhancement characteristics with quantitative perfusion parameters may provide a promising tool to help differentiate gastric cancer and GIST from benign lesions.
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Affiliation(s)
- Tingting Li
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Man Lu
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- * E-mail:
| | - Jun Song
- Department of Ultrasound, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ping Wu
- Department of Ultrasound, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xueqing Cheng
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhenqi Zhang
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Międzybrodzki K, Zaleska-Dorobisz U, Słonina J, Sokolska V, Pawluś A, Badowski R, Sąsiadek MJ. Usefulness of conventional and low-dose hydro-CT in the diagnosis of gastric tumors in comparison to endoscopy. Eur J Radiol 2017; 93:90-94. [PMID: 28668437 DOI: 10.1016/j.ejrad.2017.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of this retrospective study was to evaluate the usefulness of hydro-CT in the diagnosis of gastric tumors in comparison to endoscopy. MATERIAL AND METHODS The study involved 40 patients with a diagnosis of gastric tumor established by histopathology who underwent endoscopy and conventional or low-dose hydro-CT. Hydro-CT images were retrospectively analyzed based on the consensus of two radiologists who were blinded to the endoscopy findings. The diagnostic accuracy of hydro-CT and endoscopy for the diagnosis of gastric tumors was evaluated using the results of the histopathological examination as the reference standard. RESULTS Histopathology confirmed the presence of gastric cancer in 28 patients (70%), while gastrointestinal stromal tumors (GISTs) were recognized in the remaining 12 cases (30%). Correct diagnoses of the type of gastric tumor in hydro-CT were obtained in 37 patients (92.5%). This was not significantly different from the 85% accuracy of endoscopy. Further analysis showed that the correctness of GIST diagnosis in endoscopy and hydro-CT also did not differ significantly (91.7% and 100% respectively). The percentage of correctly diagnosed malignant lesions in hydro-CT was lower than for GISTs at 89.29%, while in endoscopy it was insignificantly lower (82.14%). The diagnostic accuracy of conventional and low-dose hydro-CT in the diagnosis of gastric tumors (95% and 90% respectively) was not significantly different. CONCLUSIONS Conventional and low-dose hydro-CT may be a valuable non-invasive diagnostic method in the diagnosis of gastric tumors for patients who have contraindications to endoscopy or who are unable to undergo gastric biopsy.
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Affiliation(s)
- Krzysztof Międzybrodzki
- Department of General and Pediatric Radiology, Chair of Radiology, Wrocław Medical University, 68 M. Curie-Skłodowskiej St., 50-369 Wrocław, Poland.
| | - Urszula Zaleska-Dorobisz
- Department of General and Pediatric Radiology, Chair of Radiology, Wrocław Medical University, 68 M. Curie-Skłodowskiej St., 50-369 Wrocław, Poland
| | - Joanna Słonina
- Department of General and Pediatric Radiology, Chair of Radiology, Wrocław Medical University, 68 M. Curie-Skłodowskiej St., 50-369 Wrocław, Poland
| | - Violetta Sokolska
- Department of General and Pediatric Radiology, Chair of Radiology, Wrocław Medical University, 68 M. Curie-Skłodowskiej St., 50-369 Wrocław, Poland
| | - Aleksander Pawluś
- Department of General and Pediatric Radiology, Chair of Radiology, Wrocław Medical University, 68 M. Curie-Skłodowskiej St., 50-369 Wrocław, Poland
| | - Roman Badowski
- Department of General and Pediatric Radiology, Chair of Radiology, Wrocław Medical University, 68 M. Curie-Skłodowskiej St., 50-369 Wrocław, Poland
| | - Marek J Sąsiadek
- Department of General Radiology, Interventional Radiology and Neuroradiology, Chair of Radiology, Wrocław Medical University, 213 Borowska St., 50-556 Wrocław, Poland
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Liu S, Liu S, Ji C, Zheng H, Pan X, Zhang Y, Guan W, Chen L, Guan Y, Li W, He J, Ge Y, Zhou Z. Application of CT texture analysis in predicting histopathological characteristics of gastric cancers. Eur Radiol 2017. [PMID: 28643092 DOI: 10.1007/s00330-017-4881-1] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To explore the application of computed tomography (CT) texture analysis in predicting histopathological features of gastric cancers. METHODS Preoperative contrast-enhanced CT images and postoperative histopathological features of 107 patients (82 men, 25 women) with gastric cancers were retrospectively reviewed. CT texture analysis generated: (1) mean attenuation, (2) standard deviation, (3) max frequency, (4) mode, (5) minimum attenuation, (6) maximum attenuation, (7) the fifth, 10th, 25th, 50th, 75th and 90th percentiles, and (8) entropy. Correlations between CT texture parameters and histopathological features were analysed. RESULTS Mean attenuation, maximum attenuation, all percentiles and mode derived from portal venous CT images correlated significantly with differentiation degree and Lauren classification of gastric cancers (r, -0.231 ~ -0.324, 0.228 ~ 0.321, respectively). Standard deviation and entropy derived from arterial CT images also correlated significantly with Lauren classification of gastric cancers (r = -0.265, -0.222, respectively). In arterial phase analysis, standard deviation and entropy were significantly lower in gastric cancers with than those without vascular invasion; however, minimum attenuation was significantly higher in gastric cancers with than those without vascular invasion. CONCLUSION CT texture analysis held great potential in predicting differentiation degree, Lauren classification and vascular invasion status of gastric cancers. KEY POINTS • CT texture analysis is noninvasive and effective for gastric cancer. • Portal venous CT images correlated significantly with differentiation degree and Lauren classification. • Standard deviation, entropy and minimum attenuation in arterial phase reflect vascular invasion.
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Affiliation(s)
- Shunli Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008
| | - Song Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008
| | - Changfeng Ji
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008
| | - Huanhuan Zheng
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008
| | - Xia Pan
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008
| | - Yujuan Zhang
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008
| | - Wenxian Guan
- Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 210008
| | - Ling Chen
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008
| | - Yue Guan
- School of Electronic Science and Engineering, Nanjing University, No. 163 Xianlin Avenue, Nanjing, China, 210046
| | - Weifeng Li
- School of Electronic Science and Engineering, Nanjing University, No. 163 Xianlin Avenue, Nanjing, China, 210046
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008.
| | - Yun Ge
- School of Electronic Science and Engineering, Nanjing University, No. 163 Xianlin Avenue, Nanjing, China, 210046.
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008.
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Karandikar A, Gummalla KM, Loke SC, Goh J, Tan TY. Approach to intensely enhancing neck nodes. Diagn Interv Radiol 2017; 22:168-72. [PMID: 26782154 DOI: 10.5152/dir.2015.14561] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Cervical node evaluation is one of the most common problems encountered by a radiologist. Here, we present a pictorial review of intensely enhancing neck nodes. While enhancement in a cervical node is a common radiologic finding on contrast-enhanced computed tomography scan, only few conditions cause intense enhancement in cervical nodes. We discuss the common causes of intensely enhancing neck nodes along with pertinent radiologic features and key differentiating points that aid radiologists in reaching a diagnosis. In addition, we discuss certain potential non-nodal mimics, which need to be excluded.
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Kang HC, Menias CO, Gaballah AH, Shroff S, Taggart MW, Garg N, Elsayes KM. Beyond the GIST: mesenchymal tumors of the stomach. Radiographics 2014; 33:1673-90. [PMID: 24108557 DOI: 10.1148/rg.336135507] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Intramural gastric masses arise in the wall of the stomach (generally within the submucosa or muscularis propria), often with intact overlying mucosa. These tumors are typically mesenchymal in origin and have overlapping radiologic appearances. A combination of features such as location, attenuation, enhancement, and growth pattern may suggest one diagnosis over another. Gastrointestinal stromal tumors (GISTs) account for the majority of intramural tumors and can vary widely in appearance, from small intraluminal lesions to exophytic masses that protrude into the peritoneal cavity, commonly with areas of hemorrhage or necrosis. A well-circumscribed mass measuring -70 to -120 HU is a lipoma. Leiomyomas usually manifest as low-attenuation masses at the gastric cardia. Homogeneous attenuation is a noteworthy characteristic of schwannomas, particularly for larger lesions that might otherwise be mistaken for GISTs. A hypervascular mass in the antrum is a common manifestation of glomus tumors. Hemangiomas are also hypervascular but often manifest in childhood. Inflammatory fibroid polyps usually arise as a polypoid mass in the antrum. Inflammatory myofibroblastic tumors are infiltrative neoplasms with a propensity for local recurrence. Plexiform fibromyxomas are rare, usually antral tumors. Carcinoid tumors are epithelial in origin, but often submucosal in location, and therefore should be distinguished from other intramural lesions. Multiple carcinoid tumors are associated with hypergastrinemia, either in the setting of chronic atrophic gastritis or Zollinger-Ellison syndrome. Sporadic solitary carcinoid tumors not associated with hypergastrinemia have a higher rate of metastasis. Histopathologic analysis, including immunohistochemistry, is usually required for diagnosis of intramural masses.
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Affiliation(s)
- Hyunseon C Kang
- Departments of Diagnostic Radiology and Pathology, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX 77030; Department of Radiology, Mayo Clinic, Tucson, Ariz
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Abstract
OBJECTIVE Recent studies have provided a better understanding of the biologic behavior of gastrointestinal carcinoid tumors. This article focusing on imaging of gastrointestinal carcinoids will emphasize epidemiology, molecular biology, taxonomy, histopathology, and management. CONCLUSION Gastrointestinal carcinoids are a biologically heterogeneous group of tumors, with variable clinical presentation and biologic behavior. Imaging can play an important role in multidisciplinary identification and management of this disease.
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Ba-Ssalamah A, Muin D, Schernthaner R, Kulinna-Cosentini C, Bastati N, Stift J, Gore R, Mayerhoefer ME. Texture-based classification of different gastric tumors at contrast-enhanced CT. Eur J Radiol 2013; 82:e537-43. [PMID: 23910996 DOI: 10.1016/j.ejrad.2013.06.024] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 05/21/2013] [Accepted: 06/28/2013] [Indexed: 12/12/2022]
Abstract
PURPOSE To determine the feasibility of texture analysis for the classification of gastric adenocarcinoma, lymphoma, and gastrointestinal stromal tumors on contrast-enhanced hydrodynamic-MDCT images. MATERIALS AND METHODS The arterial phase scans of 47 patients with adenocarcinoma (AC) and a histologic tumor grade of [AC-G1, n=4, G1, n=4; AC-G2, n=7; AC-G3, n=16]; GIST, n=15; and lymphoma, n=5, and the venous phase scans of 48 patients with AC-G1, n=3; AC-G2, n=6; AC-G3, n=14; GIST, n=17; lymphoma, n=8, were retrospectively reviewed. Based on regions of interest, texture analysis was performed, and features derived from the gray-level histogram, run-length and co-occurrence matrix, absolute gradient, autoregressive model, and wavelet transform were calculated. Fisher coefficients, probability of classification error, average correlation coefficients, and mutual information coefficients were used to create combinations of texture features that were optimized for tumor differentiation. Linear discriminant analysis in combination with a k-nearest neighbor classifier was used for tumor classification. RESULTS On arterial-phase scans, texture-based lesion classification was highly successful in differentiating between AC and lymphoma, and GIST and lymphoma, with misclassification rates of 3.1% and 0%, respectively. On venous-phase scans, texture-based classification was slightly less successful for AC vs. lymphoma (9.7% misclassification) and GIST vs. lymphoma (8% misclassification), but enabled the differentiation between AC and GIST (10% misclassification), and between the different grades of AC (4.4% misclassification). No texture feature combination was able to adequately distinguish between all three tumor types. CONCLUSION Classification of different gastric tumors based on textural information may aid radiologists in establishing the correct diagnosis, at least in cases where the differential diagnosis can be narrowed down to two histological subtypes.
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