Diagnostic performance of contrast-enhanced transabdominal ultrasound with gastric filling in preoperative T-staging of advanced gastric cancer: a retrospective study.
- 1Department of Ultrasound Medicine, Shengli Oilfield Central Hospital, Dongying, China.
Abstract
Accurate preoperative assessment of local invasion remains important in gastric cancer, particularly in distinguishing T3/T4 disease that may alter operative planning and perioperative treatment. This study evaluated the diagnostic performance of transabdominal contrast-enhanced ultrasound (CEUS) with gastric filling for preoperative T staging in surgically treated advanced gastric cancer. This retrospective single-center diagnostic accuracy study included consecutive patients who underwent CEUS with gastric filling (CEUS-GF) within 2 weeks before gastrectomy between January 2023 and December 2025 and had postoperative pathologic T2-T4 disease. Two blinded sonographers independently assigned clinical T (cT) stage; discrepant cases were adjudicated for the final imaging classification. Exact agreement, Cohen's κ, stage-specific performance, binary discrimination, receiver operating characteristic (ROC) analysis, and subgroup accuracy were assessed against postoperative pathology as the reference standard. In this cohort of 180 patients, exact agreement between final CEUS stage and pathology was 84.4%, with substantial agreement after grouping T4a and T4b as T4 (κ=0.781); initial inter-reader agreement was κ=0.822. For identifying pathologic T4 disease, sensitivity was 95.8%, specificity was 94.4%, positive predictive value was 92.0%, negative predictive value was 97.1%, and accuracy was 95.0%. Stage-specific accuracy was 90.0% for T2, 87.2% for T3, and 95.0% for grouped T4 disease. The area under the ROC curve (AUC) was 0.876 for discrimination of pathologic T stage (pT) 3-or-higher disease from pT2 and 0.966 for discrimination of pT4 from non-T4 disease. Exact T4a/T4b subclassification accuracy was 91.7%. In descriptive subgroup analyses, accuracy was numerically highest for gastric body lesions (91.8%). In this surgically treated single-center T2-T4 cohort, CEUS-GF showed good agreement with pathology and high discrimination for pathologic T4 disease. CEUS-GF may be a useful adjunct for assessing suspected serosal or extragastric extension before surgery; prospective multicenter paired-comparison studies are needed to define its incremental value beyond computed tomography (CT)/endoscopic ultrasound (EUS).
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BibTeX
@article{lv2026diagnostic,
title = {{Diagnostic performance of contrast-enhanced transabdominal ultrasound with gastric filling in preoperative T-staging of advanced gastric cancer: a retrospective study.}},
author = {Mingjia Lv and Wendi Zou and Yuan Song and Liang Dong and Wei Cui and Yan Wang and Shuang Yang},
journal = {Journal of gastrointestinal oncology},
year = {2026},
month = aug,
doi = {10.21037/jgo-2026-0800},
url = {https://europepmc.org/article/MED/42996823},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Diagnostic performance of contrast-enhanced transabdominal ultrasound with gastric filling in preoperative T-staging of advanced gastric cancer: a retrospective study.
AU - Mingjia Lv
AU - Wendi Zou
AU - Yuan Song
AU - Liang Dong
AU - Wei Cui
AU - Yan Wang
AU - Shuang Yang
PY - 2026
DA - 2026/08/30
JO - Journal of gastrointestinal oncology
DO - 10.21037/jgo-2026-0800
UR - https://europepmc.org/article/MED/42996823
AB - Accurate preoperative assessment of local invasion remains important in gastric cancer, particularly in distinguishing T3/T4 disease that may alter operative planning and perioperative treatment. This study evaluated the diagnostic performance of transabdominal contrast-enhanced ultrasound (CEUS) with gastric filling for preoperative T staging in surgically treated advanced gastric cancer. This retrospective single-center diagnostic accuracy study included consecutive patients who underwent CEUS with gastric filling (CEUS-GF) within 2 weeks before gastrectomy between January 2023 and December 2025 and had postoperative pathologic T2-T4 disease. Two blinded sonographers independently assigned clinical T (cT) stage; discrepant cases were adjudicated for the final imaging classification. Exact agreement, Cohen's κ, stage-specific performance, binary discrimination, receiver operating characteristic (ROC) analysis, and subgroup accuracy were assessed against postoperative pathology as the reference standard. In this cohort of 180 patients, exact agreement between final CEUS stage and pathology was 84.4%, with substantial agreement after grouping T4a and T4b as T4 (κ=0.781); initial inter-reader agreement was κ=0.822. For identifying pathologic T4 disease, sensitivity was 95.8%, specificity was 94.4%, positive predictive value was 92.0%, negative predictive value was 97.1%, and accuracy was 95.0%. Stage-specific accuracy was 90.0% for T2, 87.2% for T3, and 95.0% for grouped T4 disease. The area under the ROC curve (AUC) was 0.876 for discrimination of pathologic T stage (pT) 3-or-higher disease from pT2 and 0.966 for discrimination of pT4 from non-T4 disease. Exact T4a/T4b subclassification accuracy was 91.7%. In descriptive subgroup analyses, accuracy was numerically highest for gastric body lesions (91.8%). In this surgically treated single-center T2-T4 cohort, CEUS-GF showed good agreement with pathology and high discrimination for pathologic T4 disease. CEUS-GF may be a useful adjunct for assessing suspected serosal or extragastric extension before surgery; prospective multicenter paired-comparison studies are needed to define its incremental value beyond computed tomography (CT)/endoscopic ultrasound (EUS).
SN - 2078-6891
SN - 2219-679X
ER -