CT volumetry can potentially predict the local stage for gastric cancer after chemotherapy

• Published in: Diagnostic and interventional radiology (Ankara, Turkey) Vol. 23; no. 4; pp. 257 - 262
• Main Authors: Wang, Zhi Cong, Wang, Chen, Ding, Ying, Ji, Yuan, Zeng, Meng Su, Rao, Sheng Xiang
• Format: Journal Article
• Language: English
• Published: Turkey Galenos Yayinevi Tic. Ltd 01.07.2017; Aves Yayincilik Ltd. STI; Turkish Society of Radiology; Galenos Publishing House
• Subjects: Abdominal Imaging; Adult; Aged; Cancer; Care and treatment; Chemotherapy; Contrast Media; Correlation; Diagnosis; Diagnostic systems; Endoscopic ultrasonography; Female; Gastric cancer; Gears; Health aspects; Humans; Inertia; Lymph nodes; Male; Middle Aged; Neoplasm Staging; Patients; Predictions; Predictive Value of Tests; Product design; Radiographic Image Enhancement - methods; Radiotherapy; Reduction; Retrospective Studies; Sensitivity and Specificity; Stomach - diagnostic imaging; Stomach - pathology; Stomach cancer; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Tomography, X-Ray Computed - methods; Treatment Outcome; Tumor Burden; Tumors
• ISSN: 1305-3825; 1305-3612
• DOI: 10.5152/dir.2017.16517

We aimed to evaluate the value of CT tumor volumetry for predicting T and N stages of gastric cancer after chemotherapy, with pathologic results as the reference standard. This study retrospectively evaluated 42 patients diagnosed with gastric cancer, who underwent chemotherapy followed by surgery. Pre- and post-treatment CT tumor volumes (VT) were measured in portal venous phase and volume reduction ratios were calculated. Correlations between pre- and post-treatment VT, reduction ratio, and pathologic stages were analyzed. Receiver operator characteristic (ROC) analyses were also performed to assess diagnostic performance for prediction of downstaging to T0-2 stage and N0 stage. Pretreatment VT, post-treatment VT, and VT reduction ratio were significantly correlated with T stage (rs=0.329, rs=0.546, rs= -0.422, respectively). Post-treatment VT and VT reduction ratio were significantly correlated with N stage (rs=0.442 and rs= -0.376, respectively). Pretreatment VT, post-treatment VT, and VT reduction ratio were significantly different between T0-2 and T3,4 stage tumors (P = 0.05, P < 0.001, and P = 0.002, respectively). The differences between N0 and ≥N1 groups were also statistically significant (P = 0.005 for post-treatment VT, P = 0.016 for VT reduction ratio, respectively). The area under the ROC curve (AUC) for identification of T0-2 groups was 0.70 for pretreatment VT, 0.88 for post-treatment VT, and 0.82 for VT reduction ratio, respectively. AUC was 0.78 for post-treatment VT and 0.74 for VT reduction ratio for identification of N0 groups. CT tumor volumetry, particularly post-treatment measurement of VT, is potentially valuable for predicting histopathologic T and N stages after chemotherapy in patients with gastric cancer.