Improving CT detection sensitivity for nodal metastases in oesophageal cancer with combination of smaller size and lymph node axial ratio

被引:55
作者
Liu, Jianfang [1 ,2 ,3 ]
Wang, Zhu [1 ,2 ]
Shao, Huafei [4 ]
Qu, Dong [1 ,2 ]
Liu, Jian [5 ]
Yao, Libo [1 ,2 ]
机构
[1] Chinese Acad Med Sci, Natl Canc Ctr, Canc Hosp, Beijing 100021, Peoples R China
[2] Peking Union Med Coll, Beijing 100021, Peoples R China
[3] Capital Med Univ, Elect Power Teaching Hosp, Beijing 100027, Peoples R China
[4] Qingdao Univ, Coll Med, Affiliated Yantai Yuhuangding Hosp, Yantai 264000, Peoples R China
[5] Meitan Gen Hosp, Beijing 100028, Peoples R China
基金
中国国家自然科学基金;
关键词
Oesophageal squamous cell carcinoma; Lymph node metastasis; Diagnosis; MDCT; Sensitivity; SQUAMOUS-CELL CARCINOMA; POSITRON-EMISSION-TOMOGRAPHY; INFLUENCES SURVIVAL; LONG-AXIS; FDG PET; NUMBER; INFILTRATION; LYMPHADENOPATHY;
D O I
10.1007/s00330-017-4935-4
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
To investigate the value of CT with inclusion of smaller lymph node (LN) sizes and axial ratio to improve the sensitivity in diagnosis of regional lymph node metastases in oesophageal squamous cell carcinoma (OSCC). The contrast-enhanced multidetector row spiral CT (MDCT) multiplanar reconstruction images of 204 patients with OSCC were retrospectively analysed. The long-axis and short-axis diameters of the regional LNs were measured and axial ratios were calculated (short-axis/long-axis diameters). Nodes were considered round if the axial ratio exceeded the optimal LN axial ratio, which was determined by receiver operating characteristic analysis. A positive predictive value (PPV) exceeding 50% is needed. This was achieved only with LNs larger than 9 mm in short-axis diameter, but nodes of this size were rare (sensitivity 37.3%, specificity 96.4%, accuracy 85.8%). If those round nodes (axial ratio exceeding 0.66 ) between 7 mm and 9 mm in size were considered metastases as well, it might improve the sensitivity to 67.2% with a PPV of 63.9% (specificity 91.6%, accuracy 87.2%). Combination of a smaller size and axial ratio for LNs in MDCT as criteria improves the detection sensitivity for LN metastases in OSCC. aEuro cent CT is widely used to assess metastatic lymph nodes. aEuro cent CT has low sensitivity in detecting metastases using conventional criteria. aEuro cent Diagnostic sensitivity of CT was improved by using lymph node axial ratio. aEuro cent New diagnostic criteria provide greater diagnostic confidence with PPVs exceeding 50%. aEuro cent New diagnostic criteria may help clinicians assess patients with oesophageal cancer.
引用
收藏
页码:188 / 195
页数:8
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