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Radiologic Assessment of Esophageal Cancer

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Esophageal Cancer

Abstract

Esophageal cancer represents the third most common gastrointestinal tract malignancy and sixth most common cause of cancer death worldwide. The majority of esophageal cancers are either squamous cell carcinoma (SCC) or adenocarcinomas. SCC is the most common pathological subtype with a higher incidence in developing countries. Esophageal adenocarcinomas comprise 15 % of all esophageal cancers. Other malignant tumors such as sarcomas, lymphoma, and small cell carcinoma (neuroendocrine tumor) are uncommon. Accurate initial staging of esophageal cancer is required to guide treatment protocols and to estimate prognosis.

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References

  1. Kim TJ, Kim HY, Lee KW, Kim MS. Multimodality assessment of esophageal cancer: preoperative staging and monitoring of response to therapy. Radiographics. 2009;29(2):403–21. doi:10.1148/rg.292085106.

    Article  PubMed  Google Scholar 

  2. Napier KJ, Scheerer M, Misra S. Esophageal cancer: a review of epidemiology, pathogenesis, staging workup and treatment modalities. World J Gastrointest Oncol. 2014;6(5):112–20. doi:10.4251/wjgo.v6.i5.112.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Shin KE, Lee KS, Choi JY, Kim HK, Shim YM. Esophageal malignancy and staging. Semin Roentgenol. 2013;48(4):344–53. doi:10.1053/j.ro.2013.03.014.

    Article  PubMed  Google Scholar 

  4. Li Z, Rice TW. Diagnosis and staging of cancer of the esophagus and esophagogastric junction. Surg Clin North Am. 2012;92(5):1105–26. doi:10.1016/j.suc.2012.07.010.

    Article  PubMed  Google Scholar 

  5. Sonavane S, Watts Jr J, Terry N, Singh SP. Expected and unexpected imaging features after oesophageal cancer treatment. Clin Radiol. 2014;69(8):e358–66. doi:10.1016/j.crad.2014.04.003.

    Article  CAS  PubMed  Google Scholar 

  6. Rice TW. Clinical staging of esophageal carcinoma. CT, EUS, and PET. Chest Surg Clin N Am. 2000;10(3):471–85.

    CAS  PubMed  Google Scholar 

  7. Levine MS, Chu P, Furth EE, Rubesin SE, Laufer I, Herlinger H. Carcinoma of the esophagus and esophagogastric junction: sensitivity of radiographic diagnosis. AJR Am J Roentgenol. 1997;168(6):1423–6. doi:10.2214/ajr.168.6.9168701.

    Article  CAS  PubMed  Google Scholar 

  8. Flamen P, Lerut A, Van Cutsem E, De Wever W, Peeters M, Stroobants S, Dupont P, Bormans G, Hiele M, De Leyn P, Van Raemdonck D, Coosemans W, Ectors N, Haustermans K, Mortelmans L. Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma. J Clin Oncol. 2000;18(18):3202–10.

    CAS  PubMed  Google Scholar 

  9. Esteves FP, Schuster DM, Halkar RK. Gastrointestinal tract malignancies and positron emission tomography: an overview. Semin Nucl Med. 2006;36(2):169–81. doi:10.1053/j.semnuclmed.2005.12.002.

    Article  PubMed  Google Scholar 

  10. Wallace MB, Nietert PJ, Earle C, Krasna MJ, Hawes RH, Hoffman BJ, Reed CE. An analysis of multiple staging management strategies for carcinoma of the esophagus: computed tomography, endoscopic ultrasound, positron emission tomography, and thoracoscopy/laparoscopy. Ann Thorac Surg. 2002;74(4):1026–32.

    Article  PubMed  Google Scholar 

  11. Rice TW, Blackstone EH, Rusch VW. 7th edition of the AJCC cancer staging manual: esophagus and esophagogastric junction. Ann Surg Oncol. 2010;17(7):1721–4. doi:10.1245/s10434-010-1024-1.

    Article  PubMed  Google Scholar 

  12. Ulla M, Gentile E, Yeyati EL, Diez ML, Cavadas D, Garcia-Monaco RD, Ros PR. Pneumo-CT assessing response to neoadjuvant therapy in esophageal cancer: imaging-pathological correlation. World J Gastrointest Oncol. 2013;5(12):222–9. doi:10.4251/wjgo.v5.i12.222.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Puli SR, Reddy JB, Bechtold ML, Antillon D, Ibdah JA, Antillon MR. Staging accuracy of esophageal cancer by endoscopic ultrasound: a meta-analysis and systematic review. World J Gastroenterol. 2008;14(10):1479–90.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Riddell AM, Allum WH, Thompson JN, Wotherspoon AC, Richardson C, Brown G. The appearances of oesophageal carcinoma demonstrated on high-resolution, T2-weighted MRI, with histopathological correlation. Eur Radiol. 2007;17(2):391–9. doi:10.1007/s00330-006-0363-6.

    Article  CAS  PubMed  Google Scholar 

  15. van Rossum PS, van Hillegersberg R, Lever FM, Lips IM, van Lier AL, Meijer GJ, van Leeuwen MS, van Vulpen M, Ruurda JP. Imaging strategies in the management of oesophageal cancer: what’s the role of MRI? Eur Radiol. 2013;23(7):1753–65. doi:10.1007/s00330-013-2773-6.

    Article  PubMed  Google Scholar 

  16. Yasuda S, Raja S, Hubner KF. Application of whole-body positron emission tomography in the imaging of esophageal cancer: report of a case. Surg Today. 1995;25(3):261–4.

    Article  CAS  PubMed  Google Scholar 

  17. Karaosmanoglu AD, Blake MA. Applications of PET-CT in patients with esophageal cancer. Diagn Interv Radiol. 2012;18(2):171–82. doi:10.4261/1305-3825.DIR.4309-11.1.

    PubMed  Google Scholar 

  18. Kato H, Kuwano H, Nakajima M, Miyazaki T, Yoshikawa M, Ojima H, Tsukada K, Oriuchi N, Inoue T, Endo K. Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma. Cancer. 2002;94(4):921–8.

    Article  PubMed  Google Scholar 

  19. Foley KG, Fielding P, Lewis WG, Karran A, Chan D, Blake P, Roberts SA. Prognostic significance of novel (1)(8)F-FDG PET/CT defined tumour variables in patients with oesophageal cancer. Eur J Radiol. 2014;83(7):1069–73. doi:10.1016/j.ejrad.2014.03.031.

    Article  PubMed  Google Scholar 

  20. Pan L, Gu P, Huang G, Xue H, Wu S. Prognostic significance of SUV on PET/CT in patients with esophageal cancer: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2009;21(9):1008–15. doi:10.1097/MEG.0b013e328323d6fa.

    Article  PubMed  Google Scholar 

  21. Goerres GW, Von Schulthess GK, Hany TF. Positron emission tomography and PET CT of the head and neck: FDG uptake in normal anatomy, in benign lesions, and in changes resulting from treatment. AJR Am J Roentgenol. 2002;179(5):1337–43. doi:10.2214/ajr.179.5.1791337.

    Article  PubMed  Google Scholar 

  22. Nishimura H, Tanigawa N, Hiramatsu M, Tatsumi Y, Matsuki M, Narabayashi I. Preoperative esophageal cancer staging: magnetic resonance imaging of lymph node with ferumoxtran-10, an ultrasmall superparamagnetic iron oxide. J Am Coll Surg. 2006;202(4):604–11. doi:10.1016/j.jamcollsurg.2005.12.004.

    Article  PubMed  Google Scholar 

  23. Alper F, Turkyilmaz A, Kurtcan S, Aydin Y, Onbas O, Acemoglu H, Eroglu A. Effectiveness of the STIR turbo spin-echo sequence MR imaging in evaluation of lymphadenopathy in esophageal cancer. Eur J Radiol. 2011;80(3):625–8. doi:10.1016/j.ejrad.2010.08.003.

    Article  PubMed  Google Scholar 

  24. Rasanen JV, Sihvo EI, Knuuti MJ, Minn HR, Luostarinen ME, Laippala P, Viljanen T, Salo JA. Prospective analysis of accuracy of positron emission tomography, computed tomography, and endoscopic ultrasonography in staging of adenocarcinoma of the esophagus and the esophagogastric junction. Ann Surg Oncol. 2003;10(8):954–60.

    Article  PubMed  Google Scholar 

  25. Godoy MC, Bruzzi JF, Viswanathan C, Truong MT, Guimaraes MD, Hofstetter WL, Erasmus JJ, Marom EM. Multimodality imaging evaluation of esophageal cancer: staging, therapy assessment, and complications. Abdom Imaging. 2013;38(5):974–93. doi:10.1007/s00261-013-9986-7.

    Article  PubMed  Google Scholar 

  26. Moon SH, Kim HS, Hyun SH, Choi YS, Zo JI, Shim YM, Lee KH, Kim BT, Choi JY. Prediction of occult lymph node metastasis by metabolic parameters in patients with clinically N0 esophageal squamous cell carcinoma. J Nucl Med. 2014;55(5):743–8. doi:10.2967/jnumed.113.130716.

    Article  CAS  PubMed  Google Scholar 

  27. Hsu PK, Lin KH, Wang SJ, Huang CS, Wu YC, Hsu WH. Preoperative positron emission tomography/computed tomography predicts advanced lymph node metastasis in esophageal squamous cell carcinoma patients. World J Surg. 2011;35(6):1321–6. doi:10.1007/s00268-011-1081-z.

    Article  PubMed  Google Scholar 

  28. National Comprehensive Cancer Network Guidelines. Esophageal and Esophagogastric Junction Cancers (Version 1.2014). 2014. http://www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf. Accessed 20 Sept 2014.

  29. Lee G, Hoseok I, Kim SJ, Jeong YJ, Kim IJ, Pak K, Park DY, Kim GH. Clinical implication of PET/MR imaging in preoperative esophageal cancer staging: comparison with PET/CT, endoscopic ultrasonography, and CT. J Nucl Med. 2014;55(8):1242–47. doi:10.2967/jnumed.114.138974.

  30. Quint LE, Hepburn LM, Francis IR, Whyte RI, Orringer MB. Incidence and distribution of distant metastases from newly diagnosed esophageal carcinoma. Cancer. 1995;76(7):1120–5.

    Article  CAS  PubMed  Google Scholar 

  31. Bruzzi JF, Munden RF, Truong MT, Marom EM, Sabloff BS, Gladish GW, Iyer RB, Pan TS, Macapinlac HA, Erasmus JJ. PET/CT of esophageal cancer: its role in clinical management. Radiographics. 2007;27(6):1635–52. doi:10.1148/rg.276065742.

    Article  PubMed  Google Scholar 

  32. van Vliet EP, Heijenbrok-Kal MH, Hunink MG, Kuipers EJ, Siersema PD. Staging investigations for oesophageal cancer: a meta-analysis. Br J Cancer. 2008;98(3):547–57. doi:10.1038/sj.bjc.6604200.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Barber TW, Duong CP, Leong T, Bressel M, Drummond EG, Hicks RJ. 18F-FDG PET/CT has a high impact on patient management and provides powerful prognostic stratification in the primary staging of esophageal cancer: a prospective study with mature survival data. J Nucl Med. 2012;53(6):864–71. doi:10.2967/jnumed.111.101568.

    Article  PubMed  Google Scholar 

  34. Chatterton BE, Ho Shon I, Baldey A, Lenzo N, Patrikeos A, Kelley B, Wong D, Ramshaw JE, Scott AM. Positron emission tomography changes management and prognostic stratification in patients with oesophageal cancer: results of a multicentre prospective study. Eur J Nucl Med Mol Imaging. 2009;36(3):354–61. doi:10.1007/s00259-008-0959-y.

    Article  CAS  PubMed  Google Scholar 

  35. Mainenti PP, Mancini M, Mainolfi C, Camera L, Maurea S, Manchia A, Tanga M, Persico F, Addeo P, D’Antonio D, Speranza A, Bucci L, Persico G, Pace L, Salvatore M. Detection of colo-rectal liver metastases: prospective comparison of contrast enhanced US, multidetector CT, PET/CT, and 1.5 Tesla MR with extracellular and reticulo-endothelial cell specific contrast agents. Abdom Imaging. 2010;35(5):511–21. doi:10.1007/s00261-009-9555-2.

    Article  PubMed  Google Scholar 

  36. Akiyama H, Tsurumaru M, Kawamura T, Ono Y. Principles of surgical treatment for carcinoma of the esophagus: analysis of lymph node involvement. Ann Surg. 1981;194(4):438–46.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  37. Clark GW, Peters JH, Ireland AP, Ehsan A, Hagen JA, Kiyabu MT, Bremner CG, DeMeester TR. Nodal metastasis and sites of recurrence after en bloc esophagectomy for adenocarcinoma. Ann Thorac Surg. 1994;58(3):646–53. discussion 653–644.

    Article  CAS  PubMed  Google Scholar 

  38. Omloo JM, van Heijl M, Hoekstra OS, van Berge Henegouwen MI, van Lanschot JJ, Sloof GW. FDG-PET parameters as prognostic factor in esophageal cancer patients: a review. Ann Surg Oncol. 2011;18(12):3338–52. doi:10.1245/s10434-011-1732-1.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  39. Hatt M, Visvikis D, Pradier O, Cheze-le Rest C. Baseline (1)(8)F-FDG PET image-derived parameters for therapy response prediction in oesophageal cancer. Eur J Nucl Med Mol Imaging. 2011;38(9):1595–606. doi:10.1007/s00259-011-1834-9.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Brucher BL, Weber W, Bauer M, Fink U, Avril N, Stein HJ, Werner M, Zimmerman F, Siewert JR, Schwaiger M. Neoadjuvant therapy of esophageal squamous cell carcinoma: response evaluation by positron emission tomography. Ann Surg. 2001;233(3):300–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Kato H, Kuwano H, Nakajima M, Miyazaki T, Yoshikawa M, Masuda N, Fukuchi M, Manda R, Tsukada K, Oriuchi N, Endo K. Usefulness of positron emission tomography for assessing the response of neoadjuvant chemoradiotherapy in patients with esophageal cancer. Am J Surg. 2002;184(3):279–83.

    Article  PubMed  Google Scholar 

  42. Kroep JR, Van Groeningen CJ, Cuesta MA, Craanen ME, Hoekstra OS, Comans EF, Bloemena E, Hoekstra CJ, Golding RP, Twisk JW, Peters GJ, Pinedo HM, Lammertsma AA. Positron emission tomography using 2-deoxy-2-[18F]-fluoro-D-glucose for response monitoring in locally advanced gastroesophageal cancer; a comparison of different analytical methods. Mol Imaging Biol. 2003;5(5):337–46.

    Article  PubMed  Google Scholar 

  43. Smith JW, Moreira J, Abood G, Aranha GV, Nagda S, Wagner RH, Shoup M. The influence of (18)fluorodeoxyglucose positron emission tomography on the management of gastroesophageal junction carcinoma. Am J Surg. 2009;197(3):308–12. doi:10.1016/j.amjsurg.2008.10.010.

    Article  PubMed  Google Scholar 

  44. Lantos JE, Levine MS, Rubesin SE, Lau CT, Torigian DA. Comparison between esophagography and chest computed tomography for evaluation of leaks after esophagectomy and gastric pull-through. J Thorac Imaging. 2013;28(2):121–8. doi:10.1097/RTI.0b013e31826ff062.

    Article  PubMed  Google Scholar 

  45. van Westreenen HL, Cobben DC, Jager PL, van Dullemen HM, Wesseling J, Elsinga PH, Plukker JT. Comparison of 18F-FLT PET and 18F-FDG PET in esophageal cancer. J Nucl Med. 2005;46(3):400–4.

    PubMed  Google Scholar 

  46. Han D, Yu J, Zhong X, Fu Z, Mu D, Zhang B, Xu G, Yang W, Zhao S. Comparison of the diagnostic value of 3-deoxy-3-18F-fluorothymidine and 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the assessment of regional lymph node in thoracic esophageal squamous cell carcinoma: a pilot study. Dis Esophagus. 2012;25(5):416–26. doi:10.1111/j.1442-2050.2011.01259.x.

    Article  CAS  PubMed  Google Scholar 

  47. Park SH, Ryu JS, Oh SJ, Park SI, Kim YH, Jung HY, Lee GH, Song HJ, Kim JH, Song HY, Cho KJ, Kim SB. The feasibility of (18)F-fluorothymidine PET for prediction of tumor response after induction chemotherapy followed by chemoradiotherapy with S-1/oxaliplatin in patients with resectable esophageal cancer. Nucl Med Mol Imaging. 2012;46(1):57–64. doi:10.1007/s13139-011-0118-4.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  48. Chen H, Li Y, Wu H, Sun L, Lin Q, Zhao L, An H. 3’-Deoxy-3’-[F]-fluorothymidine PET/CT in early determination of prognosis in patients with esophageal squamous cell cancer: comparison with [F]-FDG PET/CT. Strahlenther Onkol. 2015;191:141–52. doi:10.1007/s00066-014-0744-8.

    Article  PubMed  Google Scholar 

  49. Chao KS. Functional imaging for early prediction of response to chemoradiotherapy: 3’-deoxy-3’-18F-fluorothymidine positron emission tomography–a clinical application model of esophageal cancer. Semin Oncol. 2006;33(6 Suppl 11):S59–63. doi:10.1053/j.seminoncol.2006.10.011.

    Article  CAS  PubMed  Google Scholar 

  50. Suzuki S, Kaira K, Ohshima Y, Ishioka NS, Sohda M, Yokobori T, Miyazaki T, Oriuchi N, Tominaga H, Kanai Y, Tsukamoto N, Asao T, Tsushima Y, Higuchi T, Oyama T, Kuwano H. Biological significance of fluorine-18-alpha-methyltyrosine (FAMT) uptake on PET in patients with oesophageal cancer. Br J Cancer. 2014;110(8):1985–91. doi:10.1038/bjc.2014.142.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

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Correspondence to A. Tuba Karagulle Kendi MD .

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Karagulle Kendi, A.T., Moncayo, V.M., Schuster, D.M. (2015). Radiologic Assessment of Esophageal Cancer. In: Saba, N., El-Rayes, B. (eds) Esophageal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-20068-2_7

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  • DOI: https://doi.org/10.1007/978-3-319-20068-2_7

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