Accuracy of Multidetector-Row Computed Tomography in the Preoperative Diagnosis of Lymph Node Metastasis in Patients with Gastric Cancer.

BACKGROUND/AIMS: Preoperative lymph node staging in gastric cancer patients is important. The aim of this study was to assess the diagnostic accuracy of computed tomography (CT) in assessing lymph nodes in patients with gastric cancer.

METHODS: A total of 56 patients had undergone standardized gastric resection with lymphadenectomy between October 2013 and June 2015 were reviewed retrospectively. The short axis diameter of the largest lymph node per station was recorded when reviewing the preoperative CT images. Diagnostic accuracy was calculated by comparing CT with histopathological findings.

RESULTS: In 518 stations dissected at surgery, 56 included lymph nodes with metastasis. Among them, lymph nodes were visualized on preoperative CT in 26 stations. No lymph node was detected in 382 stations among 462 infiltration-negative stations. The cutoff of 12 mm had the highest accuracy rate of 0.896.

CONCLUSION: The accuracy of CT in the preoperative diagnosis of lymph node metastasis in patients with gastric cancer remains poor. Therefore, surgeons should pay attention to the visibility of lymph nodes on CT. Detection of lymph nodes on CT can be utilized for a more accurate diagnosis such as fine-needle aspiration biopsy.