Neoadjuvant Therapy Clinical Trial
Official title:
Clinical Study of CT and MR in Staging and Prediction of Response in Patients With Gastric Cancer
It is very significant that assessing staging in gastric cancer patients before surgery,
furthermore, determining the optimize surgical strategy ,predict the the efficacy of
neoadjuvant therapy for patients. For patients who are ineffective in neoadjuvant therapy,
surgery will be more meaningful.
It has been reported that the application of CT(computed tomography,CT) and MR(magnetic
resonance,MR) in staging of gastric cancer, but not in predicting clinical response to
neoadjuvant therapy for gastric cancer. Only a few studies focused on T staging using
conventional MRI in gastric cancer, however , relatively new sequences in the chest deserve
widely used. To develop a pre-treatment evaluation methods for TN staging in patient with
gastric cancer by utilization of the new imaging methods (T2-TSE-BLADE,T2 maps, StarVIBE,
iShim-DWI and high resolution CT). By analysing the relationship between TN staging and
imaging features to find the imaging characteristics for TN staging, and to find the
indicators of new technology and reference values for facilitate pre-treatment diagnosis of
TN staging, optimize surgical strategy , predict the the efficacy of adjunctive therapy , and
OS and define the range of lymph node for radiotherapy , as making personal treatment
planning for gastric cancer .
To explore the value of CT and MR using multiple sequences, including T2-TSE-BLADE, T2 maps
StarVIBE, and iShim-DWI in evaluating the preoperative TN staging and prediction of response
to neoadjuvant therapy and OS in patients with gastric cancer.
Patients with endoscopically biopsy-proven gastric cancer were prospectively enrolled for
imaging on CT and a 3T MRI scanner . The MRI protocol included T2-TSE-BLADE, T2
maps,iShim-DWI(diffusion weighted imaging,DWI)and StarVIBE sequences, and so on. Patients
received treatment according to NCCN guideline(the National Comprehensive Cancer
Network,NCCN). Readers assigned a TN stage on CT and MRI, and post-operative pathologic
confirmation was considered the gold standard.
Inter-reader agreement, the diagnostic accuracy of TN staging on CT and MRI were analyzed and
compared to post-operative pathologic TN staging separately. MRI features were analyzed to
find the correlation between pretreatment MRI features and response or OS. The study will
include 400 patients. Inter-reader agreements of TN staging were analyzed excellent for CT
and MRI. Diagnostic accuracy of CT and MRI will be calculated separately.
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