KMID : 1103720130680020117
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Journal of the Korean Society of Radiology 2013 Volume.68 No. 2 p.117 ~ p.124
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Advanced Gastric Cancer: Differentiation of Borrmann Type IV versus Borrmann Type III by Two-Phased Dynamic Multi-Detector Row CT with Use of the Water Filling Method
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Kim Dae-Jung
Yu Jeong-Sik Lee Sang-Min Kim Joo-Hee Chung Jae-Joon Kim Ki-Whang Kang Hae-Youn
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Abstract
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Purpose: To characterize Borrmann type IV from Borrmann type III advanced gastric cancer (AGC) by two-phased multi-detector row computed tomography (MDCT) using the water filling method.
Materials and Methods: A total of 143 patients (pathologically confirmed Borrmann type III and IV - 100 and 43 patients), who underwent preoperative MDCT, were enrolled. Two radiologists, retrospectively and independently, determined tumor enhancement pattern using a 5-grade scale without clinical information. A weighted kappa test was applied for interobserver variability. The score of tumor enhancement pattern correlated with Borrmann type as determined by Spearman¡¯s correlation coefficient. The accuracy of differentiation of Borrmann type using MDCT was determined by receiver operating characteristic curves.
Results: Interobserver agreement (weighted kappa = 0.683) was substantial. The tumor enhancement pattern score showed a significant correlation with Borrmann type (reviewer 1, r = 0.591, p < 0.001; reviewer 2, r = 0.616, p < 0.001). The accuracy for differentiation of Borrmann type on MDCT was 0.86 (p < 0.001) in both reviewers. The sensitivity and specificity of the diagnosis of Borrmann type IV were 79% and 82% in reviewer 1, and 88% and 78% in reviewer 2, respectively.
Conclusion: Dual-phased MDCT using the water filling method can differentiate between Borrmann type IV and III AGC with high accuracy.
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KEYWORD
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Borrmann Type IV, Gastric Cancer, Computed Tomography
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