Evaluation of preoperative staging in advanced gastric cancer with MRI

AIM: To evaluate the application of magnetic resonance imaging (MRI) to the preoperative staging of advanced gastric cancer.

METHODS: An MRI (SE sequence) was preoperatively performed on 34 patients with advanced gastric cancer. The tumors were located at the cardia fundus in 11 patients, the corpus in 14, the antrum in ten and throughout the entire stomach in two. The images were analyzed and staged on the basis of the criteria proposed by Matsushita M. The results were compared with the corresponding histopathologic findings to analyze the rate of diagnostic accordance.

RESULTS: The diagnostic rate accuracy by MRI was 77.8% (seven out of nince) for T₂ tumors; 77.3% (17 out of 22) for T₃ tumors and 100% (three out of three) for T₄ tumors, with the overall accuracy equaling 79.4%. When grades T₃ and T₄ tumors were considered as a single group to determine the presence or absence of extraserosal invasion using MRI technology, the diagnostic accuracy was 88.3%. Statistically, MRI staging showed a significant correlation with the corresponding histopathologic staging using the Spearman correlation test (r_s′ = 0.743, P < 0.01). When the concordance between MRI and histopathologic staging results were studied according to tumor location, the staging accuracy was highest (90.9%) in tumors located in gastric cardia fundus.

CONCLUSION: MR imaging is moderately valuable when staging advanced gastric cancer, especially for tumors located in gastric cardia fundus.