Comparing single oral contrast-enhanced ultrasonography and double contrast-enhanced ultrasonography in the preoperative Borrmann classification of advanced gastric cancer

OBJECTIVES: To evaluate the accuracy of double contrast-enhanced ultrasonography (DCEUS) in preoperative Borrmann classification of advanced gastric cancer (AGC). MATERIALS AND METHODS: A total of 162 patients histologically confirmed AGC were enrolled into this study. Single oral contrast-enhanced ultrasonography (SOCEUS) were performed in 80 patients and DCEUS (intravenous microbubbles combined with oral contrast-enhanced ultrasound) were performed in 82 patients preoperatively. The findings of the histopathologic examination of resected specimens after surgery were considered as gold standard. The accuracy of SOCEUS was compared with the accuracy of DCEUS in determining Borrmann classification. Interobserver agreement between two sonographyers of SOCEUS and DCEUS had also been assessed. RESULTS: The accuracy of SOCEUS and DCEUS in Borrmann classification of advanced gastric cancer were 78.75% and 91.46% respectively. There was a significant difference between two methods (χ(2) = 5.186, P < 0.05). The interobserver agreement of two methods was both excellent for assessing the Borrmann classification with a Kappa value of 0.777 by SOCEUS and 0.844 by DCEUS. CONCLUSIONS: DCEUS is a valuable method for Borrmann classification with its high accuracy preoperatively. It should be used widely.