Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 28, 2011; 17(8): 1051-1057
Published online Feb 28, 2011. doi: 10.3748/wjg.v17.i8.1051
Detection of early gastric cancer using hydro-stomach CT: Blinded vs unblinded analysis
Ki Jeong Park, Min Woo Lee, Ji Hyun Koo, Yulri Park, Heejung Kim, Dongil Choi, Soon Jin Lee
Ki Jeong Park, Min Woo Lee, Ji Hyun Koo, Yulri Park, Heejung Kim, Dongil Choi, Soon Jin Lee, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, South Korea
Author contributions: Park KJ and Lee MW performed the majority of this study and wrote the manuscript; Lee MW and Choi D designed the study and performed research; Park KJ, Koo JH, Park Y, Kim H and Lee SJ were involved in the acquisition of data and in editing the manuscript.
Correspondence to: Dr. Min Woo Lee, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, South Korea. leeminwoo0@gmail.com
Telephone: +82-2-34101380 Fax: +82-2-34100049
Received: June 16, 2010
Revised: November 26, 2010
Accepted: December 3, 2010
Published online: February 28, 2011
Abstract

AIM: To evaluate the difference in diagnostic performance of hydro-stomach computed tomography (CT) to detect early gastric cancer (EGC) between blinded and unblinded analysis and to assess independent factors affecting visibility of cancer foci.

METHODS: Two radiologists initially blinded and then unblinded to gastroscopic and surgical-histological findings independently reviewed hydro-stomach CT images of 110 patients with single EGC. They graded the visibility of cancer foci for each of three gastric segments (upper, middle and lower thirds) using a 4-point scale (1: definitely absent, 2: probably absent, 3: probably present, and 4: definitely present). The sensitivity and specificity for detecting an EGC were calculated. Intraobserver and interobserver agreements were analyzed. The visibility of an EGC was evaluated with regard to tumor size, invasion depth, gastric segments, histological type and gross morphology using univariate and multivariate analysis.

RESULTS: The respective sensitivities and specificities [reviewer 1: blinded, 20% (22/110) and 98% (215/220); unblinded, 27% (30/110) and 100% (219/220)/reviewer 2: blinded, 19% (21/110) and 98% (216/220); unblinded, 25% (27/110) and 98% (215/220)] were not significantly different. Although intraobserver agreements were good (weighted κ = 0.677 and 0.666), interobserver agreements were fair (blinded, 0.371) or moderate (unblinded, 0.558). For both univariate and multivariate analyses, the tumor size and invasion depth were statistically significant factors affecting visibility.

CONCLUSION: The diagnostic performance of hydro-stomach CT to detect an EGC was not significantly different between blinded and unblinded analysis. The tumor size and invasion depth were independent factors for visibility.

Keywords: Stomach neoplasm, Computed tomography, Water, Early detection of cancer, Sensitivity