Neoplasms

Digestive System Diseases

All Conditions

Rare Diseases

Stomach Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Stomach Diseases

Stomach Cancer

All patients will be treated according to standard practice. Patients in group I are patients that will be stratified for radical gastrectomy or endoscopic resection. Group I will undergo only a primary staging. All patients will take DECT and mpMRI examination within 1 week before surgery.

Patients in group II are patients that will be stratified for neoadjuvant chemotherapy.

Group II will undergo a primary staging (DECT and mpMRI) and 1-2 times restaging (DECT and mpMRI).

DECT examinations will be performed using a 192-slice CT scanner (SOMATOM, Force, Siemens, Forchheim, Germany).

DECT examination

The examinations were conducted on a 3-T MR scanner (MAGNETOM Skyra; Siemens Healthcare, Erlangen, Germany).

mpMRI examination

Yu-Dong Zhang, MD;PHD

Accurate preoperative staging of gastric cancer is of major importance for guiding therapeutic decision-making, preventing both under- and over-treatment. The purpose of this study is to investigate the diagnostic performance of the Multi-parametric magnetic resonance imaging (mpMRI) and dual-energy computed tomography (DECT) in gastric cancer.

Gastric cancer is the leading cause of cancer-related death worldwide. The therapeutic approach to gastric cancer is strongly dependent on preoperative stage. The crucial role of gastric cancer imaging lies in implementing individualized treatment regimens according to various stages of tumor.

CT scanning has been recommended as the first-line image modality for preoperative evaluation of gastric cancer by the 8th AJCC staging manual. However, for traditional CT, the accuracy of staging is highly variable and the sensitivity of early gastric cancer detection is relatively low. Recently, DECT has been increasingly used in clinical practice due to its powerful post-processing technique. A recent small sample study showed that monoenergetic images at 40 KeV improved lesion depiction and higher T stage accuracy for gastric cancer. Therefore, this study chose DECT instead of traditional CT to explore the diagnostic performance in preoperative staging.

Historically, the role of MRI in gastric cancer has been limited, and the guidelines have not yet recommended MRI as a first-line examination scheme. But with the continuous technical improvements for abdominal imaging (e.g. breath-hold sequences and high Resolution diffusion-weighted imaging (DWI), free-breathing dynamic contrast-enhanced (DCE) sequence), mpMRI has become a promising imaging technology. In addition, given the advantages of non-radiation, non-invasiveness, and excellent soft tissue contrast, mpMRI may be more suitable for neoadjuvant therapy patients who require multiple evaluations.

Patients with gastric cancer confirmed by endoscopic biopsy will be prospectively included in this study. Patients undergo both mpMRI and DECT at baseline to stage the primary tumor, regional lymph nodes, and to rule out distant sites of disease. The interval between mpMRI and DECT examinations should not exceed 7 days. All patients will be treated according to standard practice in our institution. Patients receiving neoadjuvant chemotherapy will undergo mpMRI and DECT scan again for restaging. The postoperative pathology results of these two examination methods were prospectively collected, and their efficacy was calculated according to the reference standard. After completion of study intervention, patients are followed up periodically.

Multi-parametric MRI and Dual-energy CT in Patients of Gastric Cancer

Diagnostic Accuracy of Multi-parametric MRI and Dual-energy CT in Gastric Cancer: a Paired Validating Confirmatory Study

Accuracy for both imaging techniques in the prediction of tumor staging.

Accuracy for both imaging techniques in the prediction of tumor restaging.

Inter-rater reliability of the DECT and mpMRI in tumor assessment

Pathological tumour regression grading (Mandard criterion): from 1 to 5 grading.

Survival analysis: Radiologic data predicting DFS.

Survival analysis: Radiologic data predicting OS.

Qualitative image analysis of mpMRI in a supine and prone position

Quantitative image analysis of mpMRI in a supine and prone position.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Multi-parametric MRI and Dual-energy CT in Patients of Gastric Cancer	NCT05508126	Gastric Cancer ...	DECT examinatio... mpMRI examinati...	18 Years -	The First Affiliated Hospital with Nanjing Medical University
Multi-parametric MRI and Dual-energy CT in Patients of Gastric Cancer	NCT05508126	Gastric Cancer ...	DECT examinatio... mpMRI examinati...	18 Years -	The First Affiliated Hospital with Nanjing Medical University

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