MRI and endoscopic ultrasonography in the staging of gastric cancer.

OBJECTIVE: to determine the diagnostic precision of endoscopic ultrasounds (EUS) and magnetic resonance imaging (MRI) in the preoperative staging of gastric cancer. METHODS: a prospective, blind study was carried out in 17 patients diagnosed with gastric cancer (GC) using endoscopic biopsy from November 2002 to June 2003. Patients underwent preoperative MRI and EUS. The reference test used was pathology, and laparotomy for non-resectable cases. RESULTS: MRI (53%) was better than EUS in the assessment of gastric wall infiltration (35%). MRI (50%) was also superior to EUS (42%) for N staging. After pooling stages T1-T2 and T3-T4 together, results improved for both MRI (67 and 87.5%, respectively) and EUS (67 and 62.5%, respectively) (p < 0.05). N staging--lymph node invasion--results were correct in 50% for MRI as compared to EUS (42%). In classifying positive and negative lymph nodes EUS was superior to MRI (73 versus 54%). CONCLUSIONS: MRI was the best method in the assessment of gastric wall infiltration. EUS was superior to MRI for T1 staging, and in the assessment of lymph node infiltration.

Resonancia magnética y ecoendoscopia para el estadiaje del cáncer gástrico / MRI and endoscopic ultrasonography in the staging of gastric cancer

Objetivo: determinar cuál de las dos técnicas: ultrasonografíaendoscópica (USE) o resonancia magnética (RM) permite una mejorestadificación preoperatoria del cáncer gástrico (CG).Material y métodos: se diseñó un estudio prospectivo de lospacientes con CG diagnosticados de noviembre del 2002 a juniodel 2003. A los pacientes se les realizó una RM y una USE previaa la cirugía. El diagnóstico final de los pacientes se estableció medianteel estudio anatomopatológico de la pieza quirúrgica y/o laparotomía.Resultados: se incluyeron 17 pacientes. El grado de infiltracióntumoral de la pared gástrica (T) obtenida por RM se confirmóen el 53% de los casos y por USE en el 35%. Cuando se agrupabanlos estadios T1 y T2 el diagnóstico era correcto en el 67% delos casos tanto por la RM como para la EUS. Cuando se agrupabanel estadio T3 con el T4 el diagnóstico fue correcto en el87,5% de los casos por RM y en el 62,5% por EUS (p < 0,05). Elgrado de infiltración tumoral de los ganglios (N) por RM obtuvoconfirmación en el 50% de los casos y por USE en el 42%. Al clasificarlos ganglios en positivos (N1, N2 y N3) y negativos (N0) laUSE fue superior a la RM (73 vs. 54%).Conclusiones: la infiltración tumoral del CG en la pared gástricafue mejor valorada con la RM. La USE era mejor que la RMpara valorar el estadio T1 y la infiltración tumoral de adenopatías

Objective: to determine the diagnostic precision of endoscopicultrasounds (EUS) and magnetic resonance imaging (MRI) in thepreoperative staging of gastric cancer.Methods: a prospective, blind study was carried out in 17 patientsdiagnosed with gastric cancer (GC) using endoscopic biopsyfrom November 2002 to June 2003. Patients underwent preoperativeMRI and EUS. The reference test used was pathology, andlaparotomy for non-resectable cases.Results: MRI (53%) was better than EUS in the assessment ofgastric wall infiltration (35%). MRI (50%) was also superior to EUS(42%) for N staging. After pooling stages T1-T2 and T3-T4 together,results improved for both MRI (67 and 87.5%, respectively)and EUS (67 and 62.5%, respectively) (p < 0.05). N staging–lymph node invasion– results were correct in 50% for MRI ascompared to EUS (42%). In classifying positive and negativelymph nodes EUS was superior to MRI (73 versus 54%).Conclusions: MRI was the best method in the assessment ofgastric wall infiltration. EUS was superior to MRI for T1 staging,and in the assessment of lymph node infiltration