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Preoperative T Staging of Gastric Cancer: Comparison of Diffusion- and T2-Weighted Magnetic Resonance Imaging

Liu, Song MD*; He, Jian MD, PhD*; Guan, Wenxian MD, PhD; Li, Qiang MD, PhD; Zhang, Xiaoqi MD, PhD; Mao, Hui MD, PhD§; Yu, Haiping MD*; Zhou, Zhengyang MD, PhD*

Journal of Computer Assisted Tomography: July/August 2014 - Volume 38 - Issue 4 - p 544–550
doi: 10.1097/RCT.0000000000000090
Abdominal Imaging

Objective The objective of our study was to assess the clinical feasibility of diffusion-weighted (DW) magnetic resonance (MR) imaging in preoperative T staging of gastric cancer prospectively.

Methods Forty-five patients underwent axial T2-weighted (T2W) and DW (b, 0 and 1000 seconds/mm2) MR imaging. Two radiologists interpreted the images for detection and staging of the tumors independently. The McNemar test was used to check differences in diagnostic accuracy with the reference of postoperative histopathological results.

Results Diffusion-weighted and T2W images detected 44 and 42 of 45 histologically confirmed lesions, respectively. Furthermore, DW images detected 11 of 12 pT1 lesions compared to 9 of 12 lesions by T2W images. The staging accuracy of advanced gastric cancer (≥pT2) in DW imaging is significantly higher than that in T2W imaging (87.9% and 69.7%, respectively; P < 0.05).

Conclusions Diffusion-weighted is superior to T2W imaging in detection of early gastric cancers (pT1) and staging advanced cancers (≥pT2).

From the *Departments of Radiology, †Gastrointestinal Surgery, and Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China; and §Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.

Received for publication September 10, 2013; accepted February 18, 2014.

Reprints: Zhengyang Zhou, MD, PhD, Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Rd, Nanjing 210008, PR China (e-mail:

Song Liu, MD, and Jian He, MD, PhD, contributed equally to this manuscript.

This work was supported by Nature Science Foundation of Jiangsu Province of China [grant number BK2012531] and Nanjing City Medical Science and Technology Development–Young Start-up Projects [grant number ID yqk11159].

The authors declare no conflict of interest.

© 2014 by Lippincott Williams & Wilkins