Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Type-Specific Diagnosis and Evaluation of Longitudinal Tumor Extent of Borrmann Type IV Gastric Cancer: CT versus Gastroscopy

  • Kim, Jung Im (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center) ;
  • Kim, Young Hoon (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Lee, Kyoung Ho (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, So Yeon (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Lee, Yoon Jin (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Park, Young Soo (Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Nayoung (Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Lee, Dong Ho (Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Hyung Ho (Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Park, Do Joong (Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Lee, Hye Seung (Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
  • Received : 2012.11.08
  • Accepted : 2013.03.11
  • Published : 2013.07.01
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Abstract

Objective: To compare the accuracy of computed tomography (CT) with that of gastroscopy for the extent of evaluation of longitudinal tumor and type-specific diagnosis of Borrmann type IV gastric cancer. Materials and Methods: Fifty-nine patients (35 men with mean age of 60 years and 24 women with mean age of 55 years) who underwent surgical resection of Borrmann type IV gastric cancer were included in this study. Histopathological analysis data was used as a reference standard to confirm the clinical interpretations of gastroscopy and CT for the diagnosis of Borrmann type IV and evaluation of longitudinal tumor extent. For the evaluation of longitudinal extent, gastroscopic and CT results were classified as underestimated, accurate, or overestimated. The McNemar test was used to identify statistically significant differences in the accuracy between gastroscopy and CT. Results: For the diagnosis of Borrmann type IV gastric cancer, the accuracy of CT was significantly higher than that of gastroscopy (74.6% [44/59] vs. 44.1% [26/59], p < 0.001). CT was significantly more accurate in assessing the overall tumor extent than gastroscopy (61.4% [35/57] vs. 28.1% [16/57], p < 0.001). The proximal (75.4% [43/57] vs. 50.9% [29/57], p = 0.003) and distal tumor extent (71.9% [41/57] vs. 43.9% [25/57], p < 0.05) were more accurately predicted by CT compared with gastroscopy. The underestimation of tumor extent was a major source of error in both examinations. Conclusion: CT was found to be more predictive than gastroscopy in type-specific diagnosis and the evaluation of longitudinal tumor extent in patients with Borrmann type IV gastric cancer.

Keywords

References

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