State-of-the-art preoperative staging of gastric cancer by MDCT and magnetic resonance imaging

Abstract

Gastric cancer is one of the most common and fatal cancers. The importance of accurate staging for gastric cancer has become more critical due to the recent introduction of less invasive treatment options, such as endoscopic mucosal resection or laparoscopic surgery. The tumor-node-metastasis staging system is the generally accepted staging system for predicting the prognosis of patients with gastric cancer. Multidetector row computed tomography (MDCT) is a widely accepted imaging modality for the preoperative staging of gastric cancer that can simultaneously assess locoregional staging, including the gastric mass, regional lymph nodes, and distant metastasis. The diagnostic performance of MDCT for T- and N-staging has been improved by the technical development of isotropic imaging and 3D reformation. Although magnetic resonance imaging (MRI) was not previously used to evaluate gastric cancer due to the modality’s limitations, the development of high-speed sequences has made MRI a feasible tool for the staging of gastric cancer.

Keywords: Gastric cancer; Multidetector row computed tomography; Magnetic resonance imaging; Preoperative staging; The tumor-node-metastasis staging

Core tip: With the technical development of multiplanar imaging and 3D reformation, the diagnostic performance of Multidetector row computed tomography for T-staging has improved. N-staging of advanced gastric cancer has also improved, but the diagnostic effectiveness of N-staging is limited for patients with early gastric cancer. The limitations of magnetic resonance imaging (MRI) once prevented its use in evaluating gastric cancer; however, the development of high-speed sequences has made MRI a feasible tool. The intrinsic strength of MRI is the ability to produce contrast in soft tissue, and the use of tissue-specific contrast agents may aid in gastric cancer staging.