ArticleInsights into imaging2025
Predictive value of multivariate models combining CT-based extracellular volume fraction with clinicopathological parameters for preoperative detection of occult lymph node metastasis in gastric cancer.
Article in Insights into imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo develop multivariate models for preoperative detection of occult lymph node (LN) metastasis in gastric cancer (GC), by integrating CT-based extracellular volume (ECV) fraction and clinicopathological features, and further evaluate the prognostic value of the combined model. MATERIALS AND
methodsThis retrospective study included 129 GCs with the N (-) group (n = 49) and the N (+) group (n = 80). The preoperative CT parameters (including ECV fraction), WHO types and differentiation degree based on endoscopic pathological, and 4 hematological indices were assessed. The diagnostic performance of multivariate models was evaluated by receiver operating characteristic curve analysis.
resultsThe N (+) group demonstrated significantly higher proportions of poorly cohesive carcinoma and poor differentiation based on endoscope (both p < 0.001). Significantly higher CT-measured tumor area and ECV fraction were seen in the N (+) group (p < 0.001 and p = 0.008, respectively), and a significantly higher proportion of ECV value > 50% in the N (+) group (p = 0.001). The clinicopathological model, CT parameters model, and combined model yielded areas under the curves of 0.768, 0.774, and 0.843, respectively. The combined model with the high-risk group revealed a significantly shorter median recurrence-free survival compared to the low-risk group (p = 0.008).
conclusionThe proposed preoperative combined model exhibited a promising performance for early predicting occult LN metastasis and stratifying postoperative recurrence risk in GC, by integrating CT-based ECV fraction and clinicopathological features. CRITICAL RELEVANCE STATEMENT: The CT-based ECV preoperative model could potentially provide valuable clinical reference for making clinical strategies in GC. KEY POINTS: It is a great challenge for clinicians to evaluate occult lymph node (LN) status in gastric cancer (GC). The N (+) group demonstrated higher CT-based extracellular volume (ECV) fractions and tumor area, and higher proportions of poorly cohesive carcinoma and poor differentiation. This model helped preoperative detection of occult LN metastasis and stratifying postoperative recurrence risk in GC.
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