Magnetic Resonance Imaging in the Preoperative T Staging of Gastric Cancer (A Critical Appraisal)

Background: Gastric cancer accounts for many cancer-related deaths, is one of the top leading cause of cancer-associated mortality. Tumor staging and classification depends upon histological, immune histochemical tests along with the radiological imaging. In the preoperative T staging of gastric cancer, Magnetic Resonance Imaging (MRI) has become principal attention in recent years.

Aim: Evaluating the accuracy of MRI in the preoperative T staging of gastric cancer vis-a-vis post-operative pathological staging.

Methods: A total of 37 patients were initially taken in our study, out of which 13 patients were excluded as they underwent neo adjuvant chemoradiotherapy for the down staging of the tumor. The 24 patients became the sample size of our study and their magnetic resonance imaging (MRI) T stage was correlated with pathological T-stage.

Results: The diagnostic accuracy of T1 stage by MRI was 87.5%, with 94.7% specificity and 60% sensitivity (n=24, κ -value = 0.58; P-value<0.05). The diagnostic accuracy of T2 stage by MRI was 87.5%, with 88.2% specificity and 85.7% sensitivity (n=24, κ- value= 0.69; P-value<0.05). The diagnostic accuracy of T3 stage by MRI was 91.7% with 93.3% specificity and 88.9% sensitivity (n=24, κ -value= 0.82; P-value<0.05). The diagnostic accuracy of T4 stage by MRI was 95.8%, with 100% specificity and 75% sensitivity (n=24, κ- value= 0.80; P-value<0.05).

Conclusion: Because of high accuracy and specificity in determining the depth of invasion of gastric cancer, MRI proves to be an invaluable diagnostic tool in the preoperative T staging of gastric cancer and therefore is very useful in sidestepping unnecessary surgery by supervising the selection of treatment decisions.