title: Carcinoma of the esophagus and esophagogastric junction: sensitivity of radiographic diagnosis.
abstract: OBJECTIVE
  The purpose of this study was to determine the sensitivity of barium studies in revealing carcinoma of the esophagus and esophagogastric junction.
  
  
  METHODS
  We retrospectively reviewed 50 cases of squamous cell carcinoma of the esophagus (n = 25) and adenocarcinoma of the esophagus (n = 14) or esophagogastric junction (n = 11) in which double-contrast (n = 46) or single-contrast (n = 4) barium studies had been done. The original radiology reports were reviewed to determine whether the lesions had been seen on barium studies and whether cancer had been diagnosed. Records were also reviewed to determine the number of patients who underwent esophageal endoscopy because of findings suggestive of cancer on barium studies at some point from January 1992 through December 1992. Pathology records were then reviewed to determine the number of true- and false-positive barium studies during this same period.
  
  
  RESULTS
  Lesions were shown on barium studies in 49 (98%) of 50 patients, and carcinoma of the esophagus or esophagogastric junction was diagnosed or suspected in 48 patients (96%). In a separate part of the study, we found that endoscopy had been recommended to rule out malignant tumor in only 26 (1%) of 2484 patients who underwent barium studies at some point from January 1992 through December 1992. Endoscopy revealed cancer in 11 of those 26 patients; the remaining 15 were assumed to have false-positive radiologic examinations. Barium studies therefore had a positive predictive value of 42%.
  
  
  CONCLUSIONS
  The double-contrast barium study is a sensitive technique for the diagnosis of carcinoma of the esophagus and esophagogastric junction. This high sensitivity can be achieved while recommending endoscopy in only about 1% of all patients who undergo barium studies.
authors.affiliation: Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Levine
authors.forename: P
authors.initials: P
authors.lastname: Chu
authors.forename: E E
authors.initials: EE
authors.lastname: Furth
authors.forename: S E
authors.initials: SE
authors.lastname: Rubesin
authors.forename: I
authors.initials: I
authors.lastname: Laufer
authors.forename: H
authors.initials: H
authors.lastname: Herlinger
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D000368:Aged; D001466:Barium Sulfate; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D003287:Contrast Media; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging*; D004943:Esophagogastric Junction / Q000000981:diagnostic imaging; D004945:Esophagoscopy; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate