CEUS bests CT in early gastric cancer staging

By Amerigo Allegretto, AuntMinnie.com staff writer

November 10, 2022 -- Oral contrast-enhanced ultrasound (CEUS) is effective for detecting early gastric cancer and can assist enhanced CT in preoperative gastric cancer staging, according to a study published November 9 in Ultrasound in Medicine & Biology.

Researchers led by Ling-Ling Wu, PhD, from Tongji Medical College in Wuhan, China, suggested that CEUS has potential for preoperative gastric cancer staging and carries some advantages over CT, including lower cost, no radiation, and more convenience.

"[CEUS is] more effective for [early cancer] staging," the group wrote. "It can assist enhanced CT in accurate preoperative T staging of gastric cancer, especially in patients with ... CT contraindications, such as patients with low renal excretion and allergy to contrast agents."

Enhanced CT is the most common method for staging gastric cancer. But oral CEUS for transabdominal imaging can visualize the gastric wall, opening the door for cancer diagnosis and staging.

Wu and colleagues compared the performance of oral CEUS and enhanced CT for preoperative cancer staging, using data from 108 gastric cancer cases and postoperative pathology as the reference standard.

The team found no statistically significant differences in accuracy between the two imaging modalities for overall preoperative tumor staging diagnosis (p = 0.644). But they did find differences between the two for individual cancer stages, with CEUS performing better than enhanced CT for earlier-stage disease.

Comparison of accuracy between oral CEUS, enhanced CT for gastric cancer staging
Cancer stage Enhanced CT Oral CEUS
T1 52.6% 84.2%
T2 72.7% 81.8%
T3 87.8% 69.4%
T4 72.4% 65.5%

The researchers also found that oral CEUS performed better than enhanced CT for determining the depth of tumor invasion -- a result that could be attributed to ultrasound's "high resolution for soft tissues [which] can observe the detailed local conditions of small lesions in multiple directions," they explained.

"Among the preoperative staging methods for gastric cancer, ... enhanced CT has the disadvantages of ionizing radiation, contrast agent allergy, and a relatively high cost," the group concluded. "The advantages of [CEUS], such as low cost, no radiation, and convenience, provide clinicians and patients with more options."

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