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Article

Predictors of Metastatic Lymph Nodes at Preoperative Staging CT in Gastric Adenocarcinoma

1
Institute of Radiology, Department of Medicine-DIMED, University of Padova, 35128 Padova, Italy
2
General Surgery 3, Department of Surgical, Oncological and Gastroenterological Sciences-DISCOG, University of Padova, 35128 Padova, Italy
*
Author to whom correspondence should be addressed.
Should be considered jointly as first authors.
Should be considered jointly as senior authors.
Academic Editor: Jasper Nijkamp
Tomography 2022, 8(3), 1196-1207; https://doi.org/10.3390/tomography8030098
Received: 17 March 2022 / Revised: 19 April 2022 / Accepted: 20 April 2022 / Published: 22 April 2022
(This article belongs to the Special Issue Tumor Diagnosis and Treatment: Imaging Assessment)
Background. The aim of this study was to identify the most accurate computed-tomography (CT) dimensional criteria of loco-regional lymph nodes (LNs) for detecting nodal metastases in gastric cancer (GC) patients. Methods. Staging CTs of surgically resected GC were jointly reviewed by two radiologists, considering only loco-regional LNs with a long axis (LA) ≥ 5 mm. For each nodal group, the short axis (SA), volume and SA/LA ratio of the largest LN, the sum of the SAs of all LNs, and the mean of the SA/LA ratios were plotted in ROC curves, taking the presence/absence of metastases at histopathology for reference. On a per-patient basis, the sums of the SAs of all LNs, and the sums of the SAs, volumes, and SA/LA ratios of the largest LNs in all nodal groups were also plotted, taking the presence/absence of metastatic LNs in each patient for reference. Results. Four hundred and forty-three nodal groups were harvested during surgery from 107 patients with GC, and 173 (39.1%) were metastatic at histopathology. By nodal group, the sum of the SAs showed the best Area Under the Curve (AUC), with a sensitivity/specificity of 62.4/72.6% using Youden’s index with a >8 mm cutoff. In the per-patient analysis, the sum of the SAs of all LNs in the loco-regional nodal groups showed the best AUC with a sensitivity/specificity of 65.6%/83.7%, using Youden’s index with a >39 mm cutoff. Conclusion. In patients with GC, the sum of the SAs of all the LNs at staging CT is the best predictor among dimensional LNs criteria of both metastatic invasion of the nodal group and the presence of metastatic LNs. View Full-Text
Keywords: CT; gastric cancer; lymph node CT; gastric cancer; lymph node
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MDPI and ACS Style

Crimì, F.; Bao, Q.R.; Mari, V.; Zanon, C.; Cabrelle, G.; Spolverato, G.; Pucciarelli, S.; Quaia, E. Predictors of Metastatic Lymph Nodes at Preoperative Staging CT in Gastric Adenocarcinoma. Tomography 2022, 8, 1196-1207. https://doi.org/10.3390/tomography8030098

AMA Style

Crimì F, Bao QR, Mari V, Zanon C, Cabrelle G, Spolverato G, Pucciarelli S, Quaia E. Predictors of Metastatic Lymph Nodes at Preoperative Staging CT in Gastric Adenocarcinoma. Tomography. 2022; 8(3):1196-1207. https://doi.org/10.3390/tomography8030098

Chicago/Turabian Style

Crimì, Filippo, Quoc R. Bao, Valentina Mari, Chiara Zanon, Giulio Cabrelle, Gaya Spolverato, Salvatore Pucciarelli, and Emilio Quaia. 2022. "Predictors of Metastatic Lymph Nodes at Preoperative Staging CT in Gastric Adenocarcinoma" Tomography 8, no. 3: 1196-1207. https://doi.org/10.3390/tomography8030098

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