A Study Comparing Endoscopic Ultrasound (EUS) and Computed Tomography (CT) in Staging Oesophageal Cancer and their Role in Clinical Decision Making

Abstract

EUS staging revealed a more advanced stage of cancer in the majority of patients. It appears to be far more superior in detecting lymph node involvement compared with CT. Therefore, EUS may have a significant impact on deciding the treatment modality of a patient with oesophageal carcinoma.

Location of Lymph Node Involvement in Patients with Esophageal Adenocarcinoma Predicts Survival

“…This study shows that EUS is useful in dichotomizing patients' preoperative nodal stage into locoregionally early (onesided disease) or advanced (two-sided disease), which is very hard to do by counting individual nodes. It is the adequate preoperative assessment of clinical TNM stage that largely determines whether a patient will benefit from surgery at all or whether surgery will not cure the disease [19,20]. Other studies have examined the value of EUS as a predictor of long-term survival in esophageal cancer patients [21][22][23][24], but no study has examined the prognostic significance of the location of lymph node metastases on ultrasonography before.…”

Esophageal carcinoma: Ex vivo evaluation by high‐spatial‐resolution T2‐mapping MRI compared with histopathological findings at 3.0T

“…However, the overall prognosis of esophageal carcinoma remains poor because the initial diagnoses are at later stages . Accurate preoperative staging of esophageal carcinoma has been quite difficult by usual imaging . Computed tomography (CT) has been widely used to identify the location of a cancer, relationship to surrounding organs, and to assess the distant metastasis; however, it cannot depict the specific layer invasion of the esophageal wall due to its poor soft‐tissue resolution .…”

The Role of Magnetic Resonance Imaging in the Management of Esophageal Cancer

“…Dynamic MRI of the esophagus, using oral administration of various contrast agents, has been proposed to assess the esophageal peristalsis on sagittal images [ 15 ]. Gadopentetate dimeglumine mixed with barium [ 16 ], ferric ammonium citrate-cellulose paste [ 17 ], buttermilk spiked with gadolinium chelate [ 15 ], concentrated pineapple juice mixed with potato starch [ 18 ] were tested with satisfactory results, allowing to describe the esophagus in the sagittal plane over a mean of 16 cm, and define normal values for the esophageal transit time [ 19 , 20 ]. Noticeably, the latter intraluminal agent provided a similar image quality to those obtained with paramagnetic contrast agents.…”

“…In a more recent meta-analysis on preoperative ESCC, the overall accuracy of EUS for T-staging was 79% (95% CI: 88–94) [ 19 ]. EUS is superior to CT for evaluation of T-staging since CT cannot distinguish the different histological layers [ 20 , 22 , 23 ]. CT can be reliable when it comes to determining resectability by excluding high T-stages tumors [ 24 , 25 ].…”