title: Value of oral effervescent powder administration for multidetector CT evaluation of esophageal cancer.
abstract: OBJECTIVE
  To assess the value of oral effervescent powder (EP) for evaluation of esophageal distension, and for detection and staging of esophageal cancer with contrast-enhanced CT.
  
  
  METHODS
  84 patients without esophageal pathology and 52 patients with histological confirmed diagnosis of esophageal cancer were included in this prospective IRB-approved study. Half of the patients in both groups received EP prior to CT. Esophageal distension was assessed by planimetry of the inner (IA) and outer area (OA). Two blinded readers evaluated the datasets separately with regard to diagnosis of esophageal cancer (yes/no) and staging (T0-T4), if applicable. Distension results were compared (t-Test). In patients with cancer sensitivity, specificity, NPV and PPV were calculated. CT staging results were compared to histopathology (Cohen-k).
  
  
  RESULTS
  IA and IA/OA were significantly larger after EP as compared to the group without EP (p<0.05). Sensitivity, specificity, NPV and PPV for cancer detection cancer were as follows: 78%/78%, 98%/98%, 95%/95%, 87%/87% with EP; 60%/68%, 98%/98%, 94%/94%, 80%/83% without EP. Staging with EP was good (k=0.84/0.67) and moderate without EP (k=0.58/0.59).
  
  
  CONCLUSIONS
  Administration of EP prior to CT results in good distension of the esophagus, and improves detection and staging of esophageal cancer, as compared to control studies without EP.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. Electronic address: ringe.kristina@mh-hannover.de.
authors.forename: Kristina I
authors.initials: KI
authors.lastname: Ringe
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. Electronic address: Meyer.simone.rad@mh-hannover.de.
authors.forename: Simone
authors.initials: S
authors.lastname: Meyer
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. Electronic address: Ringe.bastian@mh-hannover.de.
authors.forename: Bastian P
authors.initials: BP
authors.lastname: Ringe
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. Electronic address: Winkler.michael@mh-hannover.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Winkler
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. Electronic address: Wacker.frank@mh-hannover.de.
authors.forename: Frank
authors.initials: F
authors.lastname: Wacker
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. Electronic address: Raatschen.hans-juergen@mh-hannover.de.
authors.forename: Hans-Juergen
authors.initials: HJ
authors.lastname: Raatschen
mesh_terms: D000284:Administration, Oral; D003287:Contrast Media / Q000008:administration & dosage*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011208:Powders / Q000008:administration & dosage*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013644:Tartrates / Q000008:administration & dosage*
chemical_list: D003287:Contrast Media; D011208:Powders; D013644:Tartrates
keywords: CT; Effervescent powder; Esophageal cancer; Esophagus