Esophageal cancer: pneumo-64-MDCT.
BACKGROUND
Pre-surgical characterization and staging of esophageal cancer with only one imaging method could be useful since gastric invasion determines the scope of resection and the kind of surgery to be performed. Our aim is to demonstrate the usefulness of Pneumo-64-MDCT (PnCT64) in the presurgical characterization of esophageal neoplasms in correlation with surgical findings.


METHODS
A total of 50 patients with diagnosis of esophageal neoplasm were prospectively studied. A 14 French Foley catheter was used transorally in all patients. Air was instilled through the catheter to achieve esophageal distension. A 64-row MDCT scan was performed and the tumor was characterized according to scope, shape and anatomic location by using multiplanar 3D reconstructions and virtual endoscopy. Wall infiltration and presence of adenopathies were analyzed.


RESULTS
Adequate gastroesophageal distension was achieved in all patients. In 44/50 patients, wall thickening was observed, and in 34/50 regional adenopathies were found. In 29/50 patients the lesion was found in the lower third and in the gastroesophageal junction. The surgical correlation for wall infiltration was 85.7%.


CONCLUSIONS
PnCT64 proved to be useful and safe for identification of esophageal wall thickening and presurgical characterization. Optimal distension allowed definition of both upper and lower borders of the tumors located in the gastroesophageal junction, of utmost importance to determine the surgical approach.
Ulla
Marina
M
Department of Radiology, Hospital Italiano de Buenos Aires, University of Buenos Aires, Potosí 4249, Buenos Aires, 1181, Argentina. marina.ulla@hospitalitaliano.org.ar
Cavadas
Demetrio
D
Muñoz
Inés
I
Beskow
Axel
A
Seehaus
Alberto
A
García-Mónaco
Ricardo
R
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000601:surgery; D002404:Catheterization; D003287:Contrast Media / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D011029:Pneumoradiography; D013270:Stomach / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol