Enhanced intensity on preoperative double contrast-enhanced sonography as a useful indicator of lymph node metastasis in patients with gastric cancer

Application of CT texture analysis in predicting histopathological characteristics of gastric cancers

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.

Malignant cardiac tumors: diagnosis and treatment

Primary malignant cardiac tumors are represented by sarcomas and non-Hodgkin lymphomas. They are rare, affect mostly patients in the fourth decade of life and have a severe prognosis. Both the diagnosis and the treatment require a multidisciplinary approach, and the cardiologist plays a central role both in the diagnosis and in the follow-up. The prognosis may be improved by a careful planning of surgery and by the use of multimodality treatment, including complementary chemotherapy and radiation therapy. A strict follow-up must be planned even after apparently complete cure.