Efficacy of multi-slice spiral computed tomography in evaluating gastric cancer recurrence after endoscopic submucosal dissection

ARTICLE HIGHLIGHTS

Research background

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).

Research motivation

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.

Research objectives

To explore the role of CT recurrence assessment in EGC patients who were treated with ESD.

Research methods

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.

Research results

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.

Research conclusions

Enhanced CT has superior diagnostic efficacy but lower accuracy than gold standard techniques in patients with recurrent EGC.

Research perspectives

Multi-slice spiral CT is valuable in EGC screening.