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Background:Gastric cancer accounts for many cancer-related deaths, is one of the top leading cause of cancer-associated mortality. Tumor staging and classification depends upon histological, immune histochemical tests along with the radiological imaging. In the preoperative T staging of gastric cancer, Magnetic Resonance Imaging (MRI) has become principal attention in recent years.Aim:Evaluating the accuracy of MRI in the preoperative T staging of gastric cancer vis-a-vis post-operative pathological staging Methods: A total of 37 patients were initially taken in our study, out of which 13 patients were excluded as they underwent neo adjuvant chemoradiotherapy for the down staging of the tumor. The 24 patients became the sample size of our study and their magnetic resonance imaging (MRI) T stage was correlated with pathological T-stage.Results:The diagnostic accuracy of T1stage by MRI was 87.5%, with 94.7% specificity and 60% sensitivity (n=24, κ -value = 0.58; P-value<0.05). The diagnostic accuracy of T2stage by MRI was 87.5%, with 88.2% specificity and 85.7% sensitivity (n=24, κ-value= 0.69; P-value<0.05). The diagnostic accuracy of T3stage by MRI was 91.7% with 93.3% specificity and 88.9% sensitivity (n=24, κ -value= 0.82; P-value<0.05). The diagnostic accuracy of T4stage by MRI was 95.8%, with 100% specificity and 75% sensitivity (n=24, κ-value= 0.80; P-value<0.05).Conclusion:Because of high accuracy and specificity in determining the depth of invasion of gastric cancer, MRI proves to be an invaluable diagnostic tool in the preoperative T staging of gastric cancer and therefore is very useful in sidestepping unnecessary surgery by supervising the selection of treatment decisions
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Abstract Introduction Papillary thyroid carcinoma has a very high rate of lateral neck node metastases, and there is almost unanimity concerning the fact that some sort of formal neck dissection must be performed to address the clinical neck disease in these cases. Although there is an agreement that levels II to IV need to be cleared in these patients, the clearance of level V is debatable. Objectives We herein have tried to analyze various papers that have documented a structured approach to neck dissection in these patients. Moreover, we have also tried to consider this issue through various aspects, like spinal accessory nerve injury and the impact of neck recurrence on survival. Data Synthesis The PubMed, Medline, Google Scholar, Surveillance, Epidemiology, and End Results (SEER), and Ovid databases were searched for studies written in English that focused on lateral neck dissection (levels II-IV or II-V) for papillary thyroid carcinoma. Case reports with 10 patients or less were excluded. Conclusions The current evidence is equivocal whether to clear level V or not, and the studies published on this issue are very heterogeneous. Level II-IV versus level II-V selective neck dissections in node-positive papillary thyroid carcinoma patients is far from categorical, with pros and cons for both approaches. Hence, we feel that there is a need for more robust homogeneous data in order to provide an answer to this question.