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AJR 2000; 174:1551-1557
© American Roentgen Ray Society

Comparing MR Imaging and CT in the Staging of Gastric Carcinoma

Kyung-Myung Sohn1, Jae Mun Lee1, Sung-Yong Lee1, Bo-Young Ahn1, Seung-Man Park2 and Kyoung-Mee Kim3

1 Department of Radiology, St. Mary's Hospital, The Catholic University of Korea, College of Medicine, 62, Youido-Dong, Yongdungpo-Gu, Seoul 150-010, Korea.
2 Department of General Surgery, The Catholic University of Korea, College of Medicine, Seoul 150-010, Korea.
3 Department of Clinical Pathology, The Catholic University of Korea, College of Medicine, Seoul 150-010, Korea.

OBJECTIVE. The purpose of this study was to assess the usefulness of breath-hold two-dimensional (2D) fast low-angle shot (FLASH) and T2-weighted turbo spin-echo fast MR imaging compared with helical CT in the staging of gastric carcinoma.

SUBJECTS AND METHODS. Thirty patients with gastric carcinoma underwent pre-operative MR imaging and helical CT. MR imaging at 1.5 T was performed immediately after the intramuscular injection of scopolamine and the oral administration of water or effervescent granules. Breath-hold 2D FLASH T1-weighted images in all three planes, turbo spin-echo T2-weighted axial images, and gadolinium-enhanced fat-suppressed 2D FLASH axial images were included. Helical CT was performed 60 sec after initiation of IV contrast medium injection (2.5-3 ml/sec). Two groups of two radiologists each independently analyzed the MR and helical CT findings, and these results were compared with the pathologic findings.

RESULTS. For T staging, MR imaging accuracy was higher than that of helical CT (73.3% and 66.7%, respectively); however, the accuracies of the two methods were not significantly different from each other (McNemar test, p > 0.05). Overstaging was noted in 6.7% of cases with MR imaging and 10% with helical CT. Understaging was noted in 20% of cases with MR imaging and 23.3% with helical CT. For N staging, the accuracies of MR imaging and helical CT were 55% and 58.6%, respectively, with no statistical significance (overstaging, 10% and 6.9%; understaging, 34.5% and 34.5%, respectively).

CONCLUSION. MR imaging was comparable to helical CT in the T and N staging of gastric cancer.


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