Published online Sep 15, 2023. doi: 10.4251/wjgo.v15.i9.1636
Peer-review started: July 4, 2023
First decision: July 19, 2023
Revised: July 25, 2023
Accepted: August 8, 2023
Article in press: August 8, 2023
Published online: September 15, 2023
There is an urgent need to develop a simple and easy approach for screening for early gastric cancer (EGC) recurrence in patients treated with endoscopic submucosal dissection (ESD).
Multi-slice spiral computed tomography (CT) is a quick, convenient and promising auxiliary examination. Enhanced spiral CT scan generates high resolution images, thus can provide a basis for the identification of gastric cancer lesions.
To explore the role of CT recurrence assessment in EGC patients who were treated with ESD.
This retrospective study recruited patients from the endoscopy department between January 2002 and December 2015. Basic characteristics, symptoms, CT results, and endoscopy with biopsy findings were analyzed. Sensitivity, specificity, negative and positive predictive values of CT for recurrent gastric cancer were calculated. Arterial and venous CT values were evaluated using area under the curve (AUC) analysis, and receiver operating characteristic curve analysis compared their performance for detecting recurrent EGC. The diagnostic efficacy and accuracy of enhanced CT were assessed in comparison to gold standard techniques for detecting recurrent EGC.
The approach had sensitivity and specificity rates of 44.22% and 43.86%, respectively, which are far from satisfactory. AUC value of arterial and venous CT values for recurrent EGC was greater than 0.5, indicating that enhanced CT can predict EGC, albeit at low accuracy.
Enhanced CT has superior diagnostic efficacy but lower accuracy than gold standard techniques in patients with recurrent EGC.
Multi-slice spiral CT is valuable in EGC screening.