Diagnostic ability of multi-detector spiral computed tomography for pathological lymph node metastasis of advanced gastric cancer

Table 1 Patient characteristics

		Retrospective	Prospective
n		69	39
Age (yr), median (range)		71.3 (54-88)	72 (42-89)
Sex	Male	48	26
	Female	21	13
Depth of invasion	pT2 (MP)	12	8
	pT3 (SS)	14	14
	pT4 (SE·SI)	43	17
Type of gastrectomy	Distal	42	25
	Total	18	11
	Others	9	3
Lymph node dissection	Limited (D0·D1)	23	12
	Standard (D1+·D2)	42	25
	Extended (D2+)	4	2
No. of lymph nodes	Detected on CT	596	301
	Harvested	2913	1328
Cases with a pathological metastasis		53	28
No. of nodes involved in the pathological metastasis		630	171

Table 2 Sensitivity and specificity of the diagnostic ability of multi-detector computed tomography in the retrospective and prospective stages based on the critical values

Critical values: 7.6 mm × 6.6 mm		Retrospective	Prospective
All locations
Long axis	Sensitivity	86.8	91.4
	Specificity	80.1	47.3
	AUC	0.706	0.849
Short axis	Sensitivity	80.8	88.9
	Specificity	72.9	52.1
	AUC	0.634	0.813
Group 1 (Nos.1-7)
Long axis	Sensitivity	89.6	97
	Specificity	80.4	49.7
	AUC	0.74	0.864
Short axis	Sensitivity	86.4	90.9
	Specificity	67.9	52.9
	AUC	0.686	0.826
Group 2 and 3 (Nos.8-16)
Long axis	Sensitivity	73.3
	Specificity	88.2
	AUC	0.638
Short axis	Sensitivity	80
	Specificity	73.5
	AUC	0.702

Table 3 Comparative distribution of lymph nodes due to the intranodal pathological metastatic pattern based on the critical value of 7.6 mm in 77 cases observed under microscopy

	SN	PP	LN	DF
> 7.6 mm	26	47	73	92
< 7.6 mm	38	120	55	93

SN: Small nodular type; PP: Peripheral type; LN: Large nodular type; DF: Diffuse type.

Table 4 Number of the nodes and distribution of morphologies on contrast-enhanced computed tomography in the prospective study

		WE		OB		RI		PA
	n	met (-)	met (+)	met (-)	met (+)	met (-)	met (+)	met (-)	met (+)
No.1	20	11		2	1			4	2
No.2	14	5	1	5	1			2
No.3	124	95	8	10	9			2
No.4	57	28	5	6	3	2	1	7	5
No.5	13	8	1					3	1
No.6	43	20	4	3	4		2	6	4
No.7	8	3	2		2			1
No.8	16	7	1		1		5	1	1
No.9	4	3					1
No.10	1						1
No.16	1	1

“No.1” to “No.16” are station numbers of regional lymph nodes of stomach, classified according to the Japanese classification of gastric carcinoma. “n” represents the sum of lymph nodes of each station visualized on CT. WE: Weak enhancement; OB: Obvious enhancement; RI: Ring enhancement; PA: Partial enhancement; met (-): No matastatic nodes; met (+): Metastatic nodes.

Table 5 Relationship between the enhanced morphology of the metastatic lymph nodes detected on multi-detector computed tomography and the intranodal pathological metastatic patterns in the prospective study

	Small nodular type	Peripheral type	Large nodular type	Diffuse type
Weak enhancement	4	7	3	8
Obvious enhancement	3	1	7	10
Ring enhancement		2	4	4
Partial enhancement	2	2	3	6