Gastric Cancer Staging: Is It Time for Magnetic Resonance Imaging?

作者：Matteo Renzulli, Alfredo Clemente, Daniele Spinelli, Anna Maria Ierardi, Giovanni Marasco, Davide Farina, Stefano Brocchi, Matteo Ravaioli, Irene Pettinari, Matteo Cescon, Alfonso Reginelli, Salvatore Cappabianca, Gianpaolo Carrafiello, Rita Golfieri · 发表于：Cancers · 年份：2020 · DOI：10.3390/cancers12061402 · 被引用次数：35 · 研究领域：Gastric Cancer Management and Outcomes、Metastasis and carcinoma case studies、Gastrointestinal Tumor Research and Treatment

Gastric cancer (GC) is a common cancer worldwide. Its incidence and mortality vary depending on geographic area, with the highest rates in Asian countries, particularly in China, Japan, and South Korea. Accurate imaging staging has become crucial for the application of various treatment strategies, especially for curative treatments in early stages. Unfortunately, most GCs are still diagnosed at an advanced stage, with the peritoneum (61-80%), distant lymph nodes (44-50%), and liver (26-38%) as the most common metastatic locations. Metastatic disease is limited to the peritoneum in 58% of cases; in nonperitoneal distant metastases, the most involved GC metastasization site is the liver (82%). The eighth edition of the tumor-node-metastasis staging system is the most commonly used system for determining GC prognosis. Endoscopic ultrasonography, computed tomography, and 18-fluorideoxyglucose positron emission tomography are historically the most accurate imaging techniques for GC staging. However, studies have recently shown renewed interest in magnetic resonance imaging (MRI) as a useful tool in GC staging, especially for distant metastasis assessment. The technical improvement of diffusion-weighted imaging and the increasing use of hepatobiliary contrast agents have been shown to increase the diagnostic performance of MRI, particularly for detecting peritoneal and liver metastasis. However, no principal oncological guidelines have included the use of MRI as a first-line techn...