Magnetic Resonance Imaging for The T Staging of Gastric Cancer: A Meta-Analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHAOShuang , TANGJing , HUANGZi-xing ,  LIURong-bo

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding?author：

LIURong-bo, Email: medicalimage@163.com

Keywords：

Magnetic resonance imaging; Gastric cancer; T staging; Meta-analysis

DOI：

10.7507/1007-9424.20140025

Video：

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Object To evaluate the sensitivity, specificity, and accuracy of magnetic resonance imaging (MRI) for the preoperative T staging of gastric cancer. Methods The databases such as the PubMed, Cochrane Database Systematic Reviews, EMbase, CNKI, and Wanfang Data were searched on computer from 1993 to 2012.The reviewers screened the trials according to inclusion and exclusion criteria strictly, extracted the data, and assessed the methodology quality.Meta-analysis were performed using the Metadisc 1.40 software, the pathology diagnosis as gold standard.The acquired pooled sensitivity, specificity, and summary receiver operating characteristic curve (SROC) were used to describe the value of MRI in T staging. Results Eight case-control studies involving 302 patients with gastric cancer were included in the study.The pooled statistical results of Meta-analysis showed that:the pooled sensitivity and specificity of MRI for T1-stage gastric cancer were 85%(55%-98%) and 97%(91%-99%) respectively, and the area under the SROC curve (AUC) was 0.961.The pooled sensitivity and specificity of MRI for T2-stage gastric cancer were 73%(60%-84%) and 93%(89%-96%) respectively, and the AUC was 0.935.The pooled sensitivity and specificity of MRI for T3-stage gastric cancer were 87%(81%-92%) and 82%(74%-88%) respectively, and the AUC was 0.914.The pooled sensitivity and specificity of MRI for T4-stage gastric cancer were 75%(62%-86%) and 97%(94%-99%) respectively, and the AUC was 0.963. Conclusion MRI has the high consistency in preoperative T staging with pathology, and should be recommended as a preferred to increase the accuracy of preoperative staging, and improve the prognosis.

Citation： ZHAOShuang, TANGJing, HUANGZi-xing, LIURong-bo. Magnetic Resonance Imaging for The T Staging of Gastric Cancer: A Meta-Analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(1): 106-111. doi: 10.7507/1007-9424.20140025 Copy

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2.	Ly QP, Sasson AR.Modern surgical considerations for gastric cancer[J].J Natl Compr Cancer Netw, 2008, 6(9):885-894.
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7.	Tsuzuki T, Okada H, Kawahara Y, et al.Usefulness and problems of endoscopic ultrasonography in prediction of the depth of tumor invasion in early gastric cancer[J].Acta Med Okayama, 2011, 65(2):105-112.
8.	Chen CY, Wu DC, Kang WY, et al.Staging of gastric cancer with 16-channel MDCT[J].Abdom Imaging, 2006, 31(5):514-520.
9.	Kim AY, Kim HJ, Ha HK.Gastric cancer by multidetector row CT:preoperative staging[J].Abdom Imaging, 2005, 30(4):465-472.
10.	Makino T, Fujiwara Y, Takiguchi S, et al.Preoperative T staging of gastric cancer by multi-detector row computed tomography[J].Surgery, 2011, 149(5):672-679.
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14.	Higgins JPT, Green S.Cochrane handbook for systematic reviews of interventions version 5.1.0[DB/OL].2009, www.cochrane-handbook.org/.
15.	Wang CK, Kuo YT, Liu GC, et al.Dynamic contrast-enhanced subtraction and delayed MRI of gastric tumors:radiologic-pathologic correlation[J].J Comput Assist Tomogr, 2000, 24(6):872-877.
16.	Kang BC, Kim JH, Kim KW, et al.Value of the dynamic and delayed MR sequence with Gd-DTPA in the T-staging of stomach cancer:correlation with the histopathology[J].Abdom Imaging, 2000, 25(1):14-24.
17.	Sohn KM, Lee JM, Lee SY, et al.Comparing MR imaging and CT in the staging of gastric carcinoma[J].AJR Am J Roentgenol, 2000, 174(6):1551-1557.
18.	湯光宇, 邢萍萍, 郭慶祿.MRI對進展期胃癌術前分期的評價[J].江西醫學院學報, 1996, 36(2):29-32.
19.	王宏, 呂劍, 方敏, 等.MRI在胃癌診斷與分期中的應用研究[J].中國醫學影像技術, 1999, 15(10):781-783.
20.	吳建勝, 陳哲京, 程駿, 等.MRI和內鏡在胃癌診斷及pT分期中的對照研究[J].實用醫學雜志, 2003, 19(9):969-970.
21.	湯群峰, 沈鈞康, 馮一中, 等.胃癌動態增強MRI表現與腫瘤血管形成關系的研究[J].中華放射學雜志, 2004, 38(10):1075-1080.
22.	邱巖, 羅婭紅, 于韜, 等.應用低場MRI平掃評價進展期胃癌的胃壁及胃周浸潤[J].實用腫瘤學雜志, 2008, 22(1:32-34.
23.	Edge SB, Byrd DR, Compton CC, et al.AJCC Cancer Staging Manual, 7th edition[M].New York:Springer-Verlag, 2010:117-126.

1. 曾紅梅, 陳萬青.中國癌癥流行病學與防治研究現狀[J].化學進展, 2013, 25(9):1415-1420.
2. Ly QP, Sasson AR.Modern surgical considerations for gastric cancer[J].J Natl Compr Cancer Netw, 2008, 6(9):885-894.
3. Kovoor PA, Hwang J.Treatment of resectable gastric cancer:current standards of care[J].Expert Rev Anticancer Ther, 2009, 9(1):135-142.
4. Hartgrink HH, Jansen EP, van Grieken NC, et al.Gastric cancer[J].Lancet, 2009, 374(9688):477-490.
5. Catalano V, Labianca R, Beretta GD, et al.Gastric cancer[J].Crit Rev Oncol Hematol, 2009, 71(2):127-164.
6. 胡建昆, 陳心足.胃癌多學科協作診療模式現狀[J].中國普外基礎與臨床雜志, 2012, 19(1):1-3.
7. Tsuzuki T, Okada H, Kawahara Y, et al.Usefulness and problems of endoscopic ultrasonography in prediction of the depth of tumor invasion in early gastric cancer[J].Acta Med Okayama, 2011, 65(2):105-112.
8. Chen CY, Wu DC, Kang WY, et al.Staging of gastric cancer with 16-channel MDCT[J].Abdom Imaging, 2006, 31(5):514-520.
9. Kim AY, Kim HJ, Ha HK.Gastric cancer by multidetector row CT:preoperative staging[J].Abdom Imaging, 2005, 30(4):465-472.
10. Makino T, Fujiwara Y, Takiguchi S, et al.Preoperative T staging of gastric cancer by multi-detector row computed tomography[J].Surgery, 2011, 149(5):672-679.
11. Furukawa K, Miyahara R, Itoh A, et al.Diagnosis of the invasion depth of gastric cancer using MDCT with virtual gastroscopy:comparison with staging with endoscopic ultrasound[J].AJR Am J Roentgenol, 2011, 197(4):867-875.
12. Tunaci M.Carcinoma of stomach and duodenum:radiologic dia-gnosis and staging[J].Eur J Radiol, 2002, 42(3):181-192.
13. Kwee RM, Kwee TC.Imaging in local staging of gastric cancer:a systematic review[J].J Clin Oncol, 2007, 25(15):2107-2116.
14. Higgins JPT, Green S.Cochrane handbook for systematic reviews of interventions version 5.1.0[DB/OL].2009, www.cochrane-handbook.org/.
15. Wang CK, Kuo YT, Liu GC, et al.Dynamic contrast-enhanced subtraction and delayed MRI of gastric tumors:radiologic-pathologic correlation[J].J Comput Assist Tomogr, 2000, 24(6):872-877.
16. Kang BC, Kim JH, Kim KW, et al.Value of the dynamic and delayed MR sequence with Gd-DTPA in the T-staging of stomach cancer:correlation with the histopathology[J].Abdom Imaging, 2000, 25(1):14-24.
17. Sohn KM, Lee JM, Lee SY, et al.Comparing MR imaging and CT in the staging of gastric carcinoma[J].AJR Am J Roentgenol, 2000, 174(6):1551-1557.
18. 湯光宇, 邢萍萍, 郭慶祿.MRI對進展期胃癌術前分期的評價[J].江西醫學院學報, 1996, 36(2):29-32.
19. 王宏, 呂劍, 方敏, 等.MRI在胃癌診斷與分期中的應用研究[J].中國醫學影像技術, 1999, 15(10):781-783.
20. 吳建勝, 陳哲京, 程駿, 等.MRI和內鏡在胃癌診斷及pT分期中的對照研究[J].實用醫學雜志, 2003, 19(9):969-970.
21. 湯群峰, 沈鈞康, 馮一中, 等.胃癌動態增強MRI表現與腫瘤血管形成關系的研究[J].中華放射學雜志, 2004, 38(10):1075-1080.
22. 邱巖, 羅婭紅, 于韜, 等.應用低場MRI平掃評價進展期胃癌的胃壁及胃周浸潤[J].實用腫瘤學雜志, 2008, 22(1:32-34.
23. Edge SB, Byrd DR, Compton CC, et al.AJCC Cancer Staging Manual, 7th edition[M].New York:Springer-Verlag, 2010:117-126.

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