Comparison of CT and MRI for the diagnosis recurrent esophageal carcinoma after operation

Abstract

Despite an increase in radical surgery for esophageal carcinoma, many patients continue to develop recurrent disease. Some reports have suggested that recurrent tumors should be treated aggressively with a combination of chemotherapy and radiotherapy. The aim of this study was to assess the comparative utility of computed tomography (CT) and magnetic resonance imaging (MRI) for the evaluation of recurrence after curative resection of cancer of the esophagus and gastroesophageal junction. To maximize survival benefit, detection of tumor recurrence as early and accurately as possible is important. Twenty-three patients who developed recurrent tumors after curative transthoracic esophagogastrectomy for esophageal carcinoma were analyzed retrospectively. The CT and MRI findings were correlated with pathology or with endoscopic and clinical follow-up. Primary tumor recurrence was detected at the anastomosis side in 19 patients (intraluminal mass in 13 and as diffuse or focal wall thickening in six). Distant recurrence was seen in the liver (n = 5), lung (n = 4), bone (n = 3), abdominal lymph node (n = 4), pleural effusion (n = 2) and pericardial effusion (n = 1). CT and MRI were found equal in showing the intraluminal mass, liver metastasis, pleural and pericardial effusion. Thickening of esophageal wall was demonstrated in nine patients using CT, but only seven of these tumor recurrences were confirmed by MRI, the remaining two were related to secondary fibrosis. Both CT and MRI showed diffuse gastric wall thickening determined as false tumor recurrence due to severe gastritis in one case. There were two (50%) false negatives for lung metastasis in MRI and one bone metastasis (33%) false negative in CT. CT was found superior in the demonstration of lung metastasis and MRI was superior in the evaluation of wall thickening and bone metastasis.

Endoscopic Ultrasound for Preoperative Esophageal Squamous Cell Carcinoma: a Meta-Analysis

“…However, CT alone is reported to have a sensitivity of 33% in lymph node involvement[ 4 ]. MRI has been reported to add information to the diagnosis and is equally as accurate as CT, but studies differ about how CT and MRI can contribute to a diagnosis and regarding their accuracy[ 5 , 6 ]. PET’s T-staging accuracy was reported to be comparable to that of EUS and might be used clinically for staging in the future[ 7 ], but the cost of using PET is generally high.…”

Comparison of different images in gross target volume delineating on VX2 nasopharyngeal transplantation tumor models

“…Both of them are closer to the GTVp than the GTV MRI and GTV CT . Both the CT and MRI methods are the first imaging choice for the staging of nasopharyngeal carcinoma [34,36,37]. The results of many studies show that diagenetic accuracy of CT and MRI are equal in the detection of abdominal lymph node metastasis, intraluminal mass and pericardial effusion [38,39].…”

Evaluation of acute esophageal radiation-induced damage using magnetic resonance imaging: a feasibility study in mice

“…MRI produces high-resolution images with good soft tissue contrast, which is ideal to distinguish organs from surrounding tissue. While MRI has been used to image the esophagus in a number of patient studies [19–22], there are no studies on imaging esophageal radiation-induced damage using MRI. ARIED manifests itself as morphological changes to the physical structure of the esophageal tissue [15].…”