Analyzing the post-contrast attenuation of the esophageal wall on routine contrast-enhanced MDCT examination can improve the diagnostic accuracy in response evaluation of the squamous cell esophageal carcinoma to neoadjuvant chemoradiotherapy in comparison with the esophageal wall thickness

Djurić-Stefanović, Aleksandra; Janković, Aleksandra; Šaponjski, Dušan; Micev, Marjan; Stojanović-Rundić, Suzana; Cosic-Micev, Milena; Peško, P

doi:10.1007/s00261-019-01911-w

Cited by 9 publications

(6 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Further, they reported that the combination of maximal esophageal wall thickness ≤9 mm and average post-contrast density ≤64 HU could correctly predict pCR. 16 However, the results of their studies did not show whether patients with a higher percentage decrease of maximal esophageal wall thickness had a better response to NCRT and survival. 11 , 12 , 16 Evaluation of the therapeutic response and prognosis solely by pre- or post-chemoradiotherapy maximal esophageal wall thickness is often influenced by individualized differences.…”

Section: Discussionmentioning

confidence: 95%

“… 16 However, the results of their studies did not show whether patients with a higher percentage decrease of maximal esophageal wall thickness had a better response to NCRT and survival. 11 , 12 , 16 Evaluation of the therapeutic response and prognosis solely by pre- or post-chemoradiotherapy maximal esophageal wall thickness is often influenced by individualized differences. In contrast, the percentage decrease of maximal esophageal wall thickness is less influenced by patient characteristics, and thus it may have more prognostic value.…”

Section: Discussionmentioning

confidence: 95%

See 1 more Smart Citation

Change in Maximal Esophageal Wall Thickness Provides Prediction of Survival and Recurrence in Patients with Esophageal Squamous Cell Carcinoma After Neoadjuvant Chemoradiotherapy and Surgery

2021

CMAR

View full text Add to dashboard Cite

This study aimed to evaluate the relationship of the percentage decrease of maximal esophageal wall thickness with pathological complete response (pCR) and recurrence in esophageal squamous cell carcinoma (ESCC). Patients and Methods: A total of 146 ESCC patients treated with neoadjuvant chemoradiotherapy (NCRT) and surgery were included. The prognostic factors for overall survival (OS) and disease-free survival (DFS) were analyzed. The recurrence site, time, and frequency were included in the analysis. The percentage decrease of maximal esophageal wall thickness after NCRT was determined with the formula: [(pre-post)/pre] × 100. Results: Overall, only 42 patients achieved pCR. Multivariable logistic analyses showed that the percentage decrease of maximal esophageal wall thickness (HR: 2.504; 95% CI: 1.112-5.638, P=0.027) was independently correlated with pCR. In multivariable Cox analyses, a ≤40% percentage decrease of maximal esophageal wall thickness was an independent adverse factor for both OS (HR: 1.907, 95% CI: 1.149-3.165; P=0.012) and DFS (HR: 2.054, 95% CI: 1.288-3.277; P=0.003). Compared with patients with a ≤40% percentage decrease, those with a >40% percentage decrease had better 5-year OS (29.0% vs 60.1%, P<0.05) and DFS (27.8% vs 54.4%, P<0.05). Perineural invasion (PNI) was also an unfavorable factor for OS (HR: 2.138, 95% CI: 0.094-4.178; P=0.026). Lymph vessel invasion (HR: 2.874, 95% CI: 1.574-5.248; P=0.001) and PNI (HR: 2.050; 95% CI: 1.044-4.023; P=0.037) were independent prognosticators for DFS. The rates of local and distant recurrence were also significantly difference between those with a percentage decrease of ≤40% and of >40% (P<0.05). Conclusion: The percentage decrease of maximal esophageal wall thickness is associated with pCR and recurrence in ESCC patients who undergo NCRT and surgery and can thus be used to independently predict prognosis.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

Change in Maximal Esophageal Wall Thickness Provides Prediction of Survival and Recurrence in Patients with Esophageal Squamous Cell Carcinoma After Neoadjuvant Chemoradiotherapy and Surgery

2021

CMAR

View full text Add to dashboard Cite

show abstract

“…For esophageal carcinoma, the thickness of the tumor measured on axial CT images represents the degree of tumor infiltration and is related to the T stage of the tumor [ 34 , 35 ]. Another previous study showed that the mean postcontrast attenuation of the esophageal wall had a higher diagnostic performance in predicting pathological complete regression (pCR) than the maximum esophageal wall thickness [ 36 ]. However, in our study, Thickness had a higher AUC value and a lower OR value when predicting LVI status.…”

Section: Discussionmentioning

confidence: 99%

Can lymphovascular invasion be predicted by contrast-enhanced CT imaging features in patients with esophageal squamous cell carcinoma? A preliminary retrospective study

Yang

Yue

et al. 2022

BMC Med Imaging

View full text Add to dashboard Cite

Background To investigate the value of contrast-enhanced CT (CECT)-derived imaging features in predicting lymphovascular invasion (LVI) status in esophageal squamous cell carcinoma (ESCC) patients. Methods One hundred and ninety-seven patients with postoperative pathologically confirmed esophageal squamous cell carcinoma treated in our hospital between January 2017 and January 2019 were enrolled in our study, including fifty-nine patients with LVI and one hundred and thirty-eight patients without LVI. The CECT-derived imaging features of all patients were analyzed. The CECT-derived imaging features were divided into quantitative features and qualitative features. The quantitative features consisted of the CT attenuation value of the tumor (CTVTumor), the CT attenuation value of the normal esophageal wall (CTVNormal), the CT attenuation value ratio of the tumor-to-normal esophageal wall (TNR), the CT attenuation value difference between the tumor and normal esophageal wall (ΔTN), the maximum thickness of the tumor measured by CECT (Thickness), the maximum length of the tumor measured by CECT (Length), and the gross tumor volume measured by CECT (GTV). The qualitative features consisted of an enhancement pattern, tumor margin, enlarged blood supply or drainage vessels to the tumor (EVFDT), and tumor necrosis. For the clinicopathological characteristics and CECT-derived imaging feature analysis, the chi-squared test was used for categorical variables, the Mann–Whitney U test was used for continuous variables with a nonnormal distribution, and the independent sample t-test was used for the continuous variables with a normal distribution. The trend test was used for ordinal variables. The association between LVI status and CECT-derived imaging features was analyzed by univariable logistic analysis, followed by multivariable logistic regression and receiver operating characteristic (ROC) curve analysis. Results The CTVTumor, TNR, ΔTN, Thickness, Length, and GTV in the group with LVI were higher than those in the group without LVI (P < 0.05). A higher proportion of patients with heterogeneous enhancement pattern, irregular tumor margin, EVFDT, and tumor necrosis were present in the group with LVI (P < 0.05). As revealed by the univariable logistic analysis, the CECT-derived imaging features, including CTVTumor, TNR, ΔTN and enhancement pattern, Thickness, Length, GTV, tumor margin, EVFDT, and tumor necrosis were associated with LVI status (P < 0.05). Only the TNR (OR 8.655; 95% CI 2.125–37.776), Thickness (OR 6.531; 95% CI 2.410–20.608), and tumor margin (OR 4.384; 95% CI 2.004–9.717) were independent risk factors for LVI in the multivariable logistic regression analysis. The ROC curve analysis incorporating the above three CECT-derived imaging features showed that the area under the curve obtained by the multivariable logistic regression model was 0.820 (95% CI 0.754–0.885). Conclusion The CECT-derived imaging features, including TNR, Thickness, tumor margin, and their combination, can be used as predictors of LVI status for patients with ESCC.

show abstract

“…The possible reasons are as follows: after radiotherapy, there are many changes in the inner mucosa of patients with esophageal cancer, such as edema, infiltration of inflammatory cells, congestion, erosion, and proliferation of connective tissue, granulation tissue, and collagen tissue in some places, which make it difficult for the thickness of the esophageal wall of patients to return to normal in a short time. Although some tumor cells were killed after radiotherapy, there was little change in the maximum tube wall thickness ( 22 – 24 ). Wu's team found that in patients with esophageal cancer undergoing radiotherapy and chemotherapy, the percentage of maximum wall thickness reduction was independently associated with pathological complete response ( p = 0.027), and could predict the recurrence of the disease ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

Application Value of Gastroenterography Combined With CT in the Evaluation of Short-Term Efficacy and Prognosis in Patients With Esophageal Cancer Radiotherapy

Xue

Linning

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

PurposeTo observe the application value of gastroenterography combined with CT in the evaluation of short-term efficacy and prognosis in patients with esophageal cancer radiotherapy.MethodsFrom January 2013 to December 2020, the clinical data of 207 patients with esophageal cancer treated by radiotherapy in our hospital were collected retrospectively. All patients received gastroenterography and CT examination before and after radiotherapy, and the patients were followed-up for 1 year, and the evaluation value of their short-term efficacy and prognosis was observed.ResultsAfter radiotherapy, the length diameter, short diameter, and volume of the lymph node were lower than those before radiotherapy (p < 0.05), but the maximum tube wall thickness had no significant difference (p > 0.05). The length diameter, short diameter, and volume of the lymph node, and the maximum tube wall thickness in the good efficacy group and the good prognosis group were lower, and the objective response rate in the good prognosis group was higher (p < 0.05). The area under the curve (AUC) of the length diameter, short diameter, and volume of the lymph node to evaluate the short-term efficacy of patients with esophageal cancer was 0.738, 0.705, and 0.748, respectively, and the AUC to evaluate the prognosis of patients with esophageal cancer was 0.751, 0.776, and 0.791, respectively.ConclusionGastroenterography combined with CT has a good application value in the evaluation of short-term efficacy and prognosis in patients with esophageal cancer radiotherapy.

show abstract

Analyzing the post-contrast attenuation of the esophageal wall on routine contrast-enhanced MDCT examination can improve the diagnostic accuracy in response evaluation of the squamous cell esophageal carcinoma to neoadjuvant chemoradiotherapy in comparison with the esophageal wall thickness

Cited by 9 publications

References 33 publications

Change in Maximal Esophageal Wall Thickness Provides Prediction of Survival and Recurrence in Patients with Esophageal Squamous Cell Carcinoma After Neoadjuvant Chemoradiotherapy and Surgery

Change in Maximal Esophageal Wall Thickness Provides Prediction of Survival and Recurrence in Patients with Esophageal Squamous Cell Carcinoma After Neoadjuvant Chemoradiotherapy and Surgery

Can lymphovascular invasion be predicted by contrast-enhanced CT imaging features in patients with esophageal squamous cell carcinoma? A preliminary retrospective study

Application Value of Gastroenterography Combined With CT in the Evaluation of Short-Term Efficacy and Prognosis in Patients With Esophageal Cancer Radiotherapy

Contact Info

Product

Resources

About