Carcinoma of the esophagus: CT vs MR imaging in determining resectability.

Takashima, S; Takeuchi, N.; Shiozaki, Hironori; Kobayashi, K; Morimoto, Setsuo; Ikezoe, Junpei; Tomiyama, Noriyuki; Harada, Kazuto; Shogen, Kin; Kozuka, T

doi:10.2214/ajr.156.2.1898802

Cited by 151 publications

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“…These advances in diagnostic procedures have allowed the selection of optimal treatment modality through clinical staging. Although there are some 'grey zones' with respect to determining T3 or T4 disease by imaging, several studies have reported the successful use of CT scans and/or magnetic resonance imaging with an accuracy rate of X80% (Picus et al, 1983;Takashima et al, 1991). We adopted their reported criterion to define T3 or T4 disease.…”

Section: Discussionmentioning

confidence: 99%

“…Bronchoscopy was performed in some cases when tracheobronchial involvement was suspected. Adjacent organs were considered to be involved if the tumours extended into the oesophageal lumen, caused deformity of the tracheobronchial tree or if the tumours appeared to be attached to the organs at a 4901 angle to the thoracic aorta as observed on the CT scan (Picus et al, 1983;Takashima et al, 1991). T3 or a lesser extent of the disease was determined by endoscopic ultrasonography.…”

Section: Eligibility Criteriamentioning

confidence: 99%

“…The patients were considered to have LYM if the tumour was X1 cm in diameter (Curtin et al, 1998). Radiological evaluations for staging were reviewed by two radiologists (TK and YM) and the physicians at Showa University School of Medicine, as was reported in previous studies (Picus et al, 1983;Takashima et al, 1991;Curtin et al, 1998). However, while the UICC staging criteria were adopted in these previous studies, we used a non-standard staging technique in this study, especially when evaluating the depth of tumour infiltration.…”

Section: Eligibility Criteriamentioning

confidence: 99%

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Definitive chemoradiotherapy for patients with malignant stricture due to T3 or T4 squamous cell carcinoma of the oesophagus

et al. 2003

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We retrospectively investigated the efficacy and feasibility of concurrent chemoradiotherapy for patients with severe dysphagia caused by oesophageal squamous cell carcinoma. Concurrent chemoradiotherapy was performed in 57 patients with T3 or T4 disease containing M1 lymph node (LYM) disease. Chemotherapy consisted of protracted infusion of 5-fluorouracil (5-FU) 400 mg m À2 24 h À1 on days 1 -5 and 8 -12, combined with 2-h infusion of cisplatin (CDDP) 40 mg m À2 on days 1 and 8. Radiation treatment at a dose of 30 Gy in 15 fractions of the mediastinum was administered concomitantly with chemotherapy. A course schedule with 3-week treatment and a 1 to 2-week break was applied twice, with a total radiation dose of 60 Gy, followed by two or more courses of 5-FU and CDDP. In all, 24 patients (42%) achieved a complete response, and the 3-year survival rate was 19%. Major toxicities were leukocytopenia and oesophagitis, and there were two (4%) treatment-related deaths. In contrast, 22 patients with T3 disease survived longer than 35 patients with T4 disease (P ¼ 0.001); however, the survival rate in 15 patients with M1 LYM disease did not differ significantly from that in 42 patients without M1 LYM disease (P ¼ 0.3545). Our results indicate that definitive chemoradiotherapy is potentially curative for locally advanced oesophageal carcinoma with malignant stricture. The efficacy and survival of patients treated with this regimen are related to the T factor.

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Section: Discussionmentioning

confidence: 99%

Section: Eligibility Criteriamentioning

confidence: 99%

Section: Eligibility Criteriamentioning

confidence: 99%

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Definitive chemoradiotherapy for patients with malignant stricture due to T3 or T4 squamous cell carcinoma of the oesophagus

et al. 2003

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“…However, chest CT alone has a sensitivity of only 48% for mediastinal lymph node involvement [10] . MRI has been shown to be useful in preoperative evaluation and equally as accurate as CT in staging esophageal cancer; however, studies do vary [11] . MRI staging has been shown to have an accuracy of 40% with very low sensitivity and specificity [12,13] .…”

Section: Introductionmentioning

confidence: 99%

Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review

Puli¹,

Jb²,

Ml³

et al. 2008

WJG

322

191

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AIM:To evaluate the accuracy of endoscopic ultrasound (EUS) in the staging of esophageal cancer. METHODS:Only EUS studies confirmed by surgery were selected. Articles were searched in Medline and Pubmed. Two reviewers independently searched and extracted data. Meta-analysis of the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratio. Pooling was conducted by both the Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran's Q test based upon inverse variance weights. RESULTS:Forty-nine studies (n = 2558) which met the inclusion criteria were included in this analysis. Pooled sensitivity and specificity of EUS to diagnose T1 was 81.6% (95% CI: 77.8-84.9) and 99.4% (95% CI: 99.0-99.7), respectively. To diagnose T4, EUS had a pooled sensitivity of 92.4% (95% CI: 89.2-95.0) and specificity of 97.4% (95% CI: 96.6-98.0). With Fine Needle Aspiration (FNA), sensitivity of EUS to diagnose N stage improved from 84.7% (95% CI: 82.9-86.4) to 96.7% (95% CI: 92.4-98.9). The P value for the χ 2 test of heterogeneity for all pooled estimates was > 0.10. CONCLUSION:EUS has excellent sensitivity and specificity in accurately diagnosing the TN stage of esophageal cancer. EUS performs better with advanced (T4) than early (T1) disease. FNA substantially improves the sensitivity and specificity of EUS in evaluating N stage disease. EUS should be strongly considered for staging esophageal cancer.

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“…Magnetic resonance imaging (MRI) provides superior soft tissue contrast, but with conventional external whole body or phased array receiver coils, image resolution of localized areas of interest is low, with staging accuracies comparable to CT (6,7). Dedicated surface receiver coils greatly improve image resolution of a localized region of interest, so that endocavitary coils are used for imaging the prostate, uterine cervix, and anal sphincter (8 -10).…”

mentioning

confidence: 99%

An inductively‐coupled, detachable receiver coil system for use with magnetic resonance compatible endoscopes

Gilderdale¹,

Williams²,

Dave³

et al. 2003

Magnetic Resonance Imaging

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PurposeTo construct an inductively‐coupled receiver coil system for use with a magnetic resonance (MR) compatible endoscope, and to evaluate its use in a pilot group of patients with esophageal cancer.Materials and MethodsAn inductively‐coupled coil system, comprising a saddle geometry cylindrical receiver coil fitted as a sleeve around the endoscope tip and a pick‐up coil housed within a channel of an MR‐compatible endoscope, was designed and developed for use at 0.5 T. Twenty‐three patients with esophageal cancer were recruited for MR endoscopy. In 17 cases, the endoscopic coil system was used in conjunction with an external surface coil in order to obtain information from the surrounding mediastinum. The examination took 40–50 minutes.ResultsMR imaging using the inductively‐coupled endoscopic coil was successful in 21 cases (one failed intubation and one artifact from unrelated external source). Image artifact was largely due to respiration and global patient motion in sedated individuals undergoing endoscopy.ConclusionInductively‐coupled coil systems may be used with endoscopes to allow improved safety through increased patient‐system isolation and detachability of coils and electronics for repair or replacement with coils tuned for different frequencies. J. Magn. Reson. Imaging 2003;18:131–135. © 2003 Wiley‐Liss, Inc.

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Carcinoma of the esophagus: CT vs MR imaging in determining resectability.

Cited by 151 publications

References 0 publications

Definitive chemoradiotherapy for patients with malignant stricture due to T3 or T4 squamous cell carcinoma of the oesophagus

Definitive chemoradiotherapy for patients with malignant stricture due to T3 or T4 squamous cell carcinoma of the oesophagus

Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review

An inductively‐coupled, detachable receiver coil system for use with magnetic resonance compatible endoscopes

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