Detection of early gastric cancer using hydro-stomach CT：Blinded vs unblinded analysis

• Published in: World journal of gastroenterology : WJG Vol. 17; no. 8; pp. 1051 - 1057
• Main Authors: Park, Ki Jeong, Lee, Min Woo, Koo, Ji Hyun, Park, Yulri, Kim, Heejung, Choi, Dongil, Lee, Soon Jin
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 28.02.2011
• Subjects: Adult; Aged; Aged, 80 and over; Brief; CT检测; Early Detection of Cancer - methods; Female; Humans; Male; Middle Aged; Observer Variation; Sensitivity and Specificity; Single-Blind Method; Stomach Neoplasms - diagnosis; Stomach Neoplasms - pathology; Tomography, X-Ray Computed - methods; Young Adult; 危险因素; 性能差异; 早期; 水电; 胃癌; 计算机断层扫描; Water; Sensitivity; Early detection of cancer; Computed tomography; Stomach neoplasm
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v17.i8.1051

AIM：To evaluate the difference in diagnostic performance of hydro-stomach computed tomography（CT） to detect early gastric cancer（EGC） between blinded and unblinded analysis and to assess independent factors affecting visibility of cancer foci.METHODS：Two radiologists initially blinded and then unblinded to gastroscopic and surgical-histological findings independently reviewed hydro-stomach CT images of 110 patients with single EGC.They graded the visibility of cancer foci for each of three gastric segments（upper,middle and lower thirds） using a 4-point scale（1：definitely absent,2：probably absent,3：probably present,and 4：definitely present）.The sensitivity and specificity for detecting an EGC were calculated.Intraobserver and interobserver agreements were analyzed.The visibility of an EGC was evaluated with regard to tumor size,invasion depth,gastric segments,histological type and gross morphology using univariate and multivariate analysis.RESULTS：The respective sensitivities and specificities [reviewer 1：blinded,20%（22/110） and 98%（215/220）;unblinded,27%（30/110） and 100%（219/220）/reviewer 2：blinded,19%（21/110） and 98%（216/220）;unblinded,25%（27/110） and 98%（215/220）] were not significantly different.Although intraobserver agreements were good（weighted κ = 0.677 and 0.666）,interobserver agreements were fair（blinded,0.371） or moderate（unblinded,0.558）.For both univariate and multivariate analyses,the tumor size and invasion depth were statistically significant factors affecting visibility.CONCLUSION：The diagnostic performance of hydrostomach CT to detect an EGC was not significantly different between blinded and unblinded analysis.The tumor size and invasion depth were independent factors for visibility.