Comparison of endoscopic ultrasonography (EUS), positron emission tomography (PET), and computed tomography (CT) in the preoperative locoregional staging of resectable esophageal cancer.
BACKGROUND
Endoscopic ultrasonography (EUS) has been a useful method for the accurate staging of esophageal cancer. This study aimed to compare the diagnostic performance of EUS, positron emission tomography (PET), and computed tomography (CT) in the locoregional staging of resectable esophageal cancer.


METHODS
A total of 109 patients with resectable esophageal cancer were prospectively enrolled and retrospectively reviewed for evaluation of preoperative EUS, PET, and CT. The sensitivity, specificity, and accuracy of tumor depth (T) staging and regional lymph nodal (N) staging for each test were compared with the postoperative histopathologic stage as the gold standard.


RESULTS
The overall accuracy of EUS for T staging was 72%, and it was the only method for delineating the layers of the esophageal wall. The sensitivities for N staging were 42% for EUS, 49% for PET, and 35% for CT, and their specificities were, respectively, 91, 87, and 93%. The accuracy for N staging was 66% for EUS, 68% for PET, and 63% for CT, and it did not differ significantly across the three tests.


CONCLUSIONS
Preoperative EUS for the locoregional staging of esophageal cancer provides excellent T staging accuracy and similar accuracy for N staging compared with PET and CT. Especially in T staging, EUS could play an important role in the choice of candidates for esophageal cancer surgery.
Choi
Jeongmin
J
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Yongun-dong 28, Chongno-gu, Seoul 110-744, South Korea.
Kim
Sang Gyun
SG
Kim
Joo Sung
JS
Jung
Hyun Chae
HC
Song
In Sung
IS
D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery; D002296:Carcinosarcoma / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*