Esophageal carcinoma. Ex vivo endoluminal magnetic resonance imaging.
OBJECTIVE
The authors evaluate ex vivo the role of endoluminal magnetic resonance imaging (MRI) in the tumor and regional lymph node staging of esophageal carcinoma.


METHODS
Nine esophagus specimens with carcinoma (seven adenocarcinoma, two squamous cell carcinoma) were studied directly after resection. Tumor (T) and regional lymph nodes (N) were classified, and the results were compared to histopathology.


RESULTS
T classification with endoluminal MRI was correct in eight of the nine tumors. One Tis tumor was staged as T1 tumor because of submucosal edema. MRI detected 35 of 91 lymph nodes. Of these 35 nodes, 14 were true-positives, 5 were false-positives, 1 was a false-negative, and 15 were true-negatives. The majority of the 56 missed lymph nodes were outside the field of view, including two specimens with a tight stricture. These lymph nodes included seven nodes with metastatic involvement. TN classification was correct in six specimens (67%).


CONCLUSIONS
This ex vivo pilot study demonstrates that T classification of esophageal carcinoma using endoluminal MRI is feasible. The results of lymph node classification are less favorable, predominantly because of the limited field of view.
Stoker
J
J
Department of Radiology, University Hospital Rotterdam Dijkzigt, The Netherlands.
van Velthuysen
M L
ML
van Overhagen
H
H
van Kempen
D
D
Tilanus
H W
HW
Laméris
J S
JS
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000175:diagnosis / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004947:Esophagus / Q000473:pathology*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging