title: Multidetector CT in patients with esophageal stent as a palliative treatment for stenosing esophageal cancer: a feasibility study.
abstract: OBJECTIVE
  The self-expanding metallic stent (SEMS) is widely used in the palliative treatment of stenosing esophageal cancer. Multidetector computed tomography (MDCT) allows volumetric investigation including virtual endoscopy. The aim of this study was to determine the feasibility of MDCT follow-up of esophageal SEMS and to describe the imaging patterns encountered as well as correlating them with fibroscopic evaluation.
  
  
  METHODS
  Thirteen consecutive patients (10 M, mean age 64 years) with esophageal SEMS as a palliative treatment underwent MDCT for recurrent dysphagia (n =7), chest pain and fever (n = 1) or follow-up without symptoms (n = 5). Patency and esophageal wall patterns were studied and compared with diagnosis by fibroscopy.
  
  
  RESULTS
  No metallic artefact related to the SEMS was observed. At the SEMS level, MDCT revealed a tissular lump (n = 1), a thin recurrent layer of tissue (n = 1), extrinsic compression (n = 1), fluid stasis (n =7) and intussusception of the gastric wall into the SEMS (n =4). The esophageal wall was analyzed by MDCT (peripheral thickening around the stent (n = 8), tumor overgrowth under or above the SEMS level (n = 8)) and showed tracheal compression (n = 3). At the level of the SEMS, fibroscopy showed tumor recurrence (n = 2), a thin recurrent layer of tissue (n = 1), a distorted SEMS (n = 1) and a tumor overgrowth under or above the SEMS level (n = 6). In comparison with fibroscopy, MDCT satisfactorily diagnosed the SEMS patency in 92% of cases and the esophageal wall in 73%.
  
  
  CONCLUSIONS
  Morphology, patency of the SEMS and analysis of the esophageal wall can be performed by MDCT with a good degree of accuracy as compared to fibroscopy. In such patients in palliative care, a non-invasive investigation is worth promoting as a first-line procedure.
authors.affiliation: QUANT-IF-EA4051, LITIS-Radiology Department, Rouen University Hospital Charles Nicolle, Rouen, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Maneglia
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ben Soussan
authors.forename: Guillaume
authors.initials: G
authors.lastname: Savoye
authors.forename: Philippe
authors.initials: P
authors.lastname: Ducrotté
authors.forename: Frédéric
authors.initials: F
authors.lastname: Di Fiore
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Dacher
authors.forename: Céline
authors.initials: C
authors.lastname: Savoye-Collet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D004945:Esophagoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011859:Radiography; D015607:Stents; D014054:Tomography / Q000379:methods*