Table 2. .
Clinical indications | Advantages | Limitations | ||||
T-staging | N-staging | M-staging | Treatment response assessment | |||
CT | Primary staging modality | Primary staging modality | Primary staging modality | All are currently insufficient to justify changes in treatment decision making |
|
|
EUS | Evaluation of possibility of endoscopic mucosal resection of early, node-negative, gastric cancer | Affirmation of N0 in patients with N0 as diagnosed by primary staging (CT) to guide neoadjuvant treatment decisions | None |
|
|
|
18F-FDG PET | None | Metabolic information improves diagnostic accuracy of CT | No conclusive evidence regarding additional diagnostic information over CT, EUS and laparoscopy |
|
|
|
MRI | Comparable diagnostic performance to CT, so indicated when CT is contraindicated or when CT results are ambiguous | Comparable performance to CT, so only indicated when CT is contraindicated or when CT results are ambiguous | Limited evidence, but can aid characterization of small liver metastases (≤10 mm). |
|
|
DCE, dynamic contrast-enhanced; DWI, diffusion-weighted imaging; EUS, endoscopic ultrasound; 18F-FDG PET, 18F-fluorodeoxyglucose positron emission tomography; FNA, fine needle aspiration; MRI, magnetic resonance imaging.