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Diagnostic Imaging of the Esophageal Cancer

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Esophageal Squamous Cell Carcinoma

Abstract

Diagnostic imaging can play an important role in detecting and staging esophageal cancer. Current diagnostic workup consists of barium esophagography, endoscopy/endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). CT, EUS, MRI, and PET should be considered complementary modalities. In combination, they are crucial to determine the most appropriate treatment for patients with esophageal cancer.

This chapter describes the diagnostic imaging, mainly of CT and MRI, and relevant anatomy of the esophagus for clinical decision making with regard to esophageal cancers. EUS precisely shows tumor invasion mainly localized in the esophageal wall (defined as T1-3). On the other hand, cross-sectional imaging such as CT and MRI is useful to detect tumor invasion to the adjacent structures beyond the adventitia (defined as T4). Currently, regional lymph node metastases are evaluated using EUS, CT, and/or FDG-PET. Detection of metastatic lymphadenopathies on CT depends primarily on nodal size (size criteria) although size is known to be an insensitive parameter. MRI’s role to assess regional nodal metastasis is limited so far. CT is currently the best diagnostic method to detect metastases.

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References

  1. American Joint Committee on Cancer (2010) Edge SB et al (ed) AJCC Cancer Staging Manual seventh edition Springer-Verlag, New York

    Google Scholar 

  2. Mancuso AA (2011) Cervical esophagus. In: Mancuso AA (ed) Head and neck radiology. Lippincott Williams & Wilkins, a Wolters Kluwer, Philadelphia

    Google Scholar 

  3. Hasegawa N, Niwa Y, Arisawa T et al (1996) Preoperative staging of superficial esophageal carcinoma: comparison of an ultrasound probe and standard endoesopic ultrasonography. Gastrointest Endosc 39:388–392

    Google Scholar 

  4. Postlethwait RW (1983) Carcinoma of the thoracic esophagus. Surg Clin North Am 63:933–940

    PubMed  CAS  Google Scholar 

  5. Kim TJ, Kim HY, Lee KW et al (2009) Multimodality assessment of esophageal cancer: preoperative staging and monitoring of response to therapy. Radiographics 29:403–421

    Article  PubMed  Google Scholar 

  6. Levine MS, Rubesin SE (2005) Diseases of the esophagus: diagnosis with esophagography. Radiology 237:414–427

    Article  PubMed  Google Scholar 

  7. The Japan Esophageal Society (2008) Japanese classification of esophageal cancer, 10th edn. Kanehara Co. Ltd, Tokyo

    Google Scholar 

  8. Levine MS, Chu P, Furth EE et al (1997) Carcinoma of the esophagus and esophagogastric junction: sensitivity of radiographic diagnosis. AJR Am J Roentgenol 168:1423–1426

    Article  PubMed  CAS  Google Scholar 

  9. Levine MS, Halvorsen RA (1994) Esophageal carcinoma. In: Core RM, Levine MS, Laufer I (eds) Textbook of gastrointestinal radiology. WB Saunders Co, Philadelphia

    Google Scholar 

  10. Wakelin SJ, Deans C, Crofts TJ et al (2002) A comparison of computerized tomography, laparoscopic ultrasound and endoscopic ultrasound in the preoperative staging of oesophago-gastric carcinoma. Eur J Radiol 41:161–167

    Article  PubMed  Google Scholar 

  11. Preston ST, Clark GW, Martin IG et al (2003) Effect of endoscopic ultrasonography on the management of 100 consecutive patients with oesophageal and junctional carcinoma. Br J Surg 90:1220–1224

    Article  PubMed  CAS  Google Scholar 

  12. Holsher AH, Dittler HJ, Siewert JR (1994) Staging of squamous esophageal cancer: accuracy and value. World J Surg 18:312–320

    Article  Google Scholar 

  13. van den Hoed RD, Feldberg MAM, van Leeuwen MS et al (1997) CT prediction of irresectability in esophageal carcinoma: value of additional patient positions and relation to patient outcome. Abdom Imaging 22:132–137

    Article  PubMed  Google Scholar 

  14. Thompson WM, Halvorsen RA, Foster WL Jr et al (1983) Computed tomography for staging esophageal and gastroesophgaeal cancer: reevaluation. AJR Am J Roentgenol 141:951–958

    Article  PubMed  CAS  Google Scholar 

  15. Halvorsen RA Jr, Thompson WM (1987) Computed tomographic staging of gastrointestinal malignancies. I. Esophagus and stomach. Invest Radiol 22:2–16

    Article  PubMed  Google Scholar 

  16. Umeoka S, Koyama T, Togashi K et al (2006) Esophageal cancer: evaluation with triple-phase dynamic CT – initial experience. Radiology 239:777–783

    Article  PubMed  Google Scholar 

  17. Umeoka S, Okada T, Daido S et al (2013) “Early esophageal rim enhancement”: a new sign of esophageal cancer on dynamic CT. Eur J Radiol 82:459–463

    Article  PubMed  Google Scholar 

  18. Yoon YC, Lee KS, Shim YM et al (2003) Metastasis to regional lymph nodes in patients with esophageal squamous cell carcinoma: CT versus FDG PET for presurgical detection prospective study. Radiology 227:764–770

    Article  PubMed  Google Scholar 

  19. Desai RK, Tagliabue JR, Wegryn SA et al (1991) CT evaluation of wall thickening in the alimentary tract. Radiographics 11:771–783

    Article  PubMed  CAS  Google Scholar 

  20. Xia F, Mao J, Ding J, Yang H (2009) Observation of normal appearance and wall thickness of esophagus on CT images. Eur J Radiol 72:406–411

    Article  PubMed  Google Scholar 

  21. Liao ZX, Liu H, Komaki R (2003) Target delineation for esophageal cancer. J Women’s Imaging 5:177–186

    Article  Google Scholar 

  22. Moss AA, Schnyder P, Thoeni RF et al (1981) Esophageal carcinoma: pretherapy staging by computed tomography. Am J Roentgenol 136:1051–1056

    Article  CAS  Google Scholar 

  23. Noh HM, Fishman EK, Forastiere AA et al (1995) CT of the esophagus: spectrum of disease with emphasis on esophageal carcinoma. Radiographics 15:1113–1134

    Article  PubMed  CAS  Google Scholar 

  24. Van Rossum PSN, van Hillegersberg R, Lever FM et al (2013) Imaging strategies in the management of oesophageal cancer: what’s the role of MRI? Eur Radiol 23:1753–1765

    Google Scholar 

  25. Picus D, Balfe DM, Koehler RE et al (1983) Computed tomography in the staging of esophageal carcinoma. Radiology 46:433–438

    Article  Google Scholar 

  26. Daffner RH, Halber MD, Postlethwait RW et al (1979) CT of the esophagus. II. Carcinoma. AJR Am J Roentgenol 133:1051–1055

    Article  PubMed  CAS  Google Scholar 

  27. Lehr L, Rupp N, Siewert JR (1988) Assessment of resectability of esophageal cancer by computed tomography and magnetic resonance imaging. Surgery 103:344–350

    PubMed  CAS  Google Scholar 

  28. Takashima S, Takeuchi N, Shiozaki H et al (1991) Carcinoma of the esophagus: CT vs MR imaging in determining resectability. AJR Am J Roentgenol 156:297–302

    Article  PubMed  CAS  Google Scholar 

  29. Quint LE, Bogot NR (2008) Staging esophageal cancer. Cancer Imag 8:S33–S42, Sepec No A

    Article  Google Scholar 

  30. Lefor AT, Merino MM, Steinberg SM et al (1989) Computerized tomographic prediction of extraluminal spread and prognostic implications of lesion width in esophageal cancer (abstr). Radiology 171:290

    Article  Google Scholar 

  31. Ruf G, Brobmann GF, Grosser G et al (1985) Wert der Computer-tomographie fur die Beurteiling der lokalen Operabilitat und die chirurgische Verfahrenswahl beim Oesophaguscarcinoom. Langenbecks Arch Chir 365:157–168

    Article  PubMed  CAS  Google Scholar 

  32. Ogawa Y, Nischiyama K, Ikesoe J et al (1987) Preoperative assessment of tumor invasions of the intrathoracic esophageal carcinoma. In: Siewert JR, Holscher AH (eds) Diseases of the esophagus, 1st edn. Springer, New York, pp 203–206

    Google Scholar 

  33. Sakurada A, Takahara T, Kwee IC et al (2009) Diagnostic performance of diffusion-weighted magnetic resonance imaging in esophageal cancer. Eur Radiol 19:1461–1469

    Article  PubMed  Google Scholar 

  34. Tio TL, Cohen P, Coene PP et al (1987) Endosonography and computed tomography of esophageal carcinoma; preoperative classification compared to the new (1987) TNM system. Gastroenterology 96:1478–1486

    Google Scholar 

  35. Iyer RB, Silverman PM, Tamm EP et al (2003) Imaging in oncology from the University of Texas M.D. Anderson Cancer Center. Diagnosis, staging, and follow-up of esophageal cancer. AJR Am J Roentgenol 181:785–793

    Article  PubMed  Google Scholar 

  36. Block MI, Patterson GA, Sundaresan RS et al (1997) Improvement in staging of esophageal cancer with the addition of positron emission tomography. Ann Thorac Surg 64:770–777

    Article  PubMed  CAS  Google Scholar 

  37. Kato H, Kuwano H, Nakajima M et al (2002) Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma. Cancer 94:921–928

    Article  PubMed  Google Scholar 

  38. Van Vliet EP, Heijenbrok-Kal MH, Hunink MG et al (2008) Staging investigation for oesophageal cancer: a meta-analysis. Br J Cancer 98:547–557

    Article  PubMed  PubMed Central  Google Scholar 

  39. Van Westreenen HL, Westerterp M, Bossuyt PM et al (2004) Systematic review of the staging performance of 18F-fluiorodeoxyglucose positron emission tomography in esophageal cancer. J Clin Oncol 22:3805–3812

    Article  PubMed  Google Scholar 

  40. Quint LE, Hepbum LM, Francis IR et al (1995) Incidence and distribution of distant metastases from newly diagnosed esophageal carcinoma. Cancer 76:1120–1125

    Article  PubMed  CAS  Google Scholar 

  41. Mandard AM, Chasle J, Marnay J et al (1981) Autopsy findings in 111 cases of esophageal cancer. Cancer 48:329–335

    Article  PubMed  CAS  Google Scholar 

  42. Flanagan FL, Dehdashti F, Siegel BA et al (1997) Staging of esophageal cancer with 18F-fluirodeoxyglucose positron emission tomography. AJR Am J Roentgenol 168:417–424

    Article  PubMed  CAS  Google Scholar 

  43. Flamen P, Lerut A, Van Cutsem E et al (2000) Utility of positron emission tomography for the staging of patients with potentially operable esophageal carcinoma. J Clin Oncol 18:3202–3210

    PubMed  CAS  Google Scholar 

  44. Downey RJ, Akhurst T, Ilson D et al (2003) Whole body 18FDG-PET and the response of esophageal cancer to induction therapy: results of the prospective trial. J Clin Oncol 21:428

    Article  PubMed  Google Scholar 

  45. Rice TW (2000) Clinical staging of esophageal carcinoma. CT, EUS, and PET. Chest Surg Clin N Am 10:471–485

    PubMed  CAS  Google Scholar 

  46. Carlisle JG, Quint LE, Francis IR et al (1993) Recurrent esophageal carcinoma: CT evaluation after esophagectomy. Radiology 189:271–275

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Hiroya Ojiri MD

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  1. Hiroya Ojiri MD
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Correspondence to Hiroya Ojiri MD .

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Editors and Affiliations

  1. Department of Surgery, International Goodwill Hospital, Yokohama, Kanagawa, Japan

    Nobutoshi Ando

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Ojiri, H. (2015). Diagnostic Imaging of the Esophageal Cancer. In: Ando, N. (eds) Esophageal Squamous Cell Carcinoma. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54977-2_3

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  • DOI: https://doi.org/10.1007/978-4-431-54977-2_3

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  • Print ISBN: 978-4-431-54976-5

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