Lymph node metastasis in patients with gastric cancer: a multi-modality, morphologic and functional imaging study

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Accurate staging of gastric cancer, particularly lymph node metastasis detection, is crucial for treatment planning.
• Conventional imaging modalities have limitations in precisely identifying lymph node involvement.

Purpose of the Study:

• To evaluate the diagnostic value of computed tomography (CT), magnetic resonance imaging (MRI), and diffusion-weighted imaging (DWI) for detecting lymph node metastasis in gastric cancer patients prior to treatment.

Main Methods:

• Eighty-two gastric cancer patients underwent CT, morphological MRI (T2WI), and DWI.
• Two radiologists independently assessed lymph node involvement.
• Pathological findings served as the gold standard; statistical analyses included t-tests and ROC curve analysis (AUC).

Main Results:

• Positive lymph nodes showed significantly lower apparent diffusion coefficient (ADC) values and larger short diameters compared to negative nodes.
• The combined AUC for CT, MRI, and DWI (0.893) was significantly higher than individual modalities.
• DWI (AUC 0.797) outperformed morphological MRI (AUC 0.733); CT and morphological MRI showed no significant difference.

Conclusions:

• The combination of CT, MRI, and DWI offers superior accuracy for detecting lymph node metastasis in gastric cancer compared to each modality alone.
• DWI demonstrates a significant advantage over morphological MRI in this diagnostic context.