AI-Assisted Detection and Staging of Gastric Cancer Using Contrast-Enhanced CT

Adults with confirmed gastric cancer undergoing pre-treatment CECT will be enrolled. The AI analysis will be applied to clinically acquired images. Radiologist interpretations with and without AI support will be collected in a prespecified reader study. The reference standard will include surgical pathology, supplemented by clinical follow-up when applicable. The primary outcome is detection performance, diagnostic performance of the AI for four-class staging (e.g., accuracy and area under the receiver operating characteristic curve). Secondary outcomes include the effect of AI assistance on reader accuracy and interpretation time, inter-reader agreement, and cross-site reproducibility.

Inclusion criteria

• pathologically confirmed gastric cancer;
• preoperative contrast-enhanced CT performed;
• no evidence of distant metastasis on baseline staging;
• curative-intent management with complete postoperative histopathology.

Exclusion criteria

• prior treatment before surgery;
• non-diagnostic or poor-quality CT precluding evaluation.