Progressive CT system technology and experience improve the perceived preoperative stage of gastric cancer.
Progressive CT system technology and experience improve the perceived preoperative stage of gastric cancer.
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DOI：
10.1007/s10120-004-0311-6
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发表时间：
2005-01-01
期刊：
影响因子：
--
通讯作者：
Thomas, Gerald V
中科院分区：
文献类型：
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作者：
Blackshaw, Guy R J C;Stephens, Michael R;Thomas, Gerald V
背景：我们的目标是测量专业螺旋计算机断层扫描 (CT) 在胃癌术前分期中的准确性，确定渐进式 CT 系统技术的相对益处，并确定放射学解释中任何学习曲线的大小。 方法：100 名患者（中位年龄 70 岁；范围 27-86 岁；68 名男性）接受了术前 CT（73 螺旋 [hCT]，27 多层 [mCT]），由一位专业放射科医生进行治疗，然后在 3 周内进行手术。通过加权 Kappa 统计量 (Kw) 确定每个 CT 系统以及 25 名患者的四个连续队列的感知 CT 分期和组织病理学分期之间的一致性强度。结果：T、N、M1 肝脏和 M1 腹膜分期的 Kw 值（hCT 为 0.40、0.18、0.36 和 0.09），而 hCT 为 0.57， mCT 为 0.67、0.66（所有 P < 0.001）和 0.24（P = 0.06）。 T、N分期的Serial Kw从第一四分位患者的0.26和-0.14提高到最后四分位患者的0.61和0.73（P < 0.001）。结论：随着CT技术的进步，CT在胃癌术前分期中的作用越来越强。
BACKGROUND: Our goals were to measure the accuracy of specialist helical computed tomography (CT) in the preoperative staging of gastric cancer, to determine the relative benefit of progressive CT system technology, and to determine the magnitude of any learning curve in radiological interpretation.METHODS: One hundred patients (median age, 70 years; range 27-86 years; 68 male) underwent a preoperative CT (73 helical [hCT], 27 multislice [mCT]), performed by a single specialist radiologist, followed by surgery within 3 weeks. The strength of the agreement between the perceived CT stage and the histopathological stage was determined for each CT system and also for four serial cohorts of 25 patients, by the weighted Kappa statistic (Kw).RESULTS: The Kw values for T, N, M1 liver, and M1 peritoneal stage were 0.40, 0.18, 0.36, and 0.09 for hCT, compared with 0.57, 0.67, 0.66 (all P < 0.001), and 0.24 (P = 0.06) for mCT. Serial Kw for T and N stages improved from 0.26 and -0.14 in the first quartile of patients to 0.61 and 0.73 (P < 0.001) in the last quartile of patients.CONCLUSION: The role of CT in the preoperative staging of gastric cancer is becoming stronger as CT technology improves.