Three-dimensional MDCT imaging and CT esophagography for evaluation of esophageal tumors: preliminary study.
The aim of this study was to determine whether multidetector computed tomography (MDCT) imaging, including CT esophagography (CTE), can be used as a comprehensive imaging test for esophageal tumors. Twenty-three patients with esophageal neoplasms underwent MDCT with esophageal distension and endoscopy. Of them, 20 underwent barium study. Two radiologists independently reviewed MDCT images with 3D CT esophagography (CTE) including CT endoscopy and were asked to determine the presence of the esophageal lesions and characterize them using a five-point confidence scale. The radiologists' performance for the lesion detection and characterization was evaluated by receiver operating characteristic (ROC) analysis. They were also requested to determine the local staging of esophageal cancer, and the overall accuracies of MDCT for local staging were calculated. The ability of MDCT with CTE was also evaluated compared with conventional studies. CTE images successfully revealed 14 of 16 esophageal cancers and all seven submucosal tumors. Two esophageal cancers, both confined to the mucosal layer, were undetected. The Az values of the MDCT images were 0.954-0.957 for determining the presence of a lesion and 0.954-0.995 for differentiating between cancer and submucosal tumors. The overall accuracies for T and N staging were 42.9% and 85.7%, respectively. In 80% and 74% of cases, CTE gave similar or superior information to barium study and endoscopy, respectively. MDCT esophagography has the potential to serve as a comprehensive imaging modality for evaluating esophageal tumors as it provides accurate information regarding the detection and characterization of esophageal tumors as well as the similar information to conventional studies.
Kim
Se Hyung
SH
Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, Seoul, 110-744, South Korea.
Lee
Jeong Min
JM
Han
Joon Koo
JK
Kim
Young Hwan
YH
Lee
Jae Young
JY
Lee
Hyun-Ju
HJ
Shin
Kyung-Sook
KS
Choi
Byung Ihn
BI
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D004945:Esophagoscopy; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007723:Korea / Q000453:epidemiology; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000473:pathology; D007890:Leiomyosarcoma / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015588:Observer Variation; D012107:Research Design; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation
D003287:Contrast Media; D001466:Barium Sulfate