Accuracy of dual-contrast gastrointestinal ultrasonography in predicting lymph node metastasis in older adults with gastric cancer.

[BACKGROUND] Gastrointestinal dual-contrast ultrasonography (DCUS) is characterized by its high resolution, sensitivity, and specificity.

[AIM] To determine the accuracy of DCUS in predicting lymph node metastasis in middle-aged and elderly patients with gastric cancer (GC).

[METHODS] A total of 100 middle-aged and elderly patients with GC admitted to the Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital, Suzhou, China) between April 2022 and April 2024 were selected. The baseline data and lymph node metastasis status were collected. DCUS combined with intravenous contrast technology was used to calculate the enhancement time (ET), time to peak (TTP), and slope of the ascending branch wash-in rate (WIR). These indicators were used in assessing lymph node metastasis in patients with GC.

[RESULTS] Among 100 middle-aged and elderly patients with GC, 35 (35.00%) had lymph node metastases. GC patients with lymph node metastasis had a higher proportion of stage II TNM classification and higher WIR values than those without lymph node metastasis. The ET and TTP values were lower in patients with lymph node metastases, and all differences were statistically significant ( < 0.05). The area under the curve values for ET, TTP, WIR, and combined diagnosis of GC lymph node metastasis using DCUS were all > 0.7. Optimal assessment was achieved when the cutoff values for ET, TTP, and WIR were set at 16.32 seconds, 10.67 seconds, and 7.02, respectively.

[CONCLUSION] DCUS-mediated assessment of ET, TTP, and WIR can effectively predict and evaluate lymph node metastasis status in patients with GC, with higher sensitivity when used in combination.