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Aorta and tracheobronchial invasion in esophageal cancer: comparing diagnostic performance of 3.0-T MRI and CT

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To compare between the diagnostic performance of 3.0-T MRI and CT for aorta and tracheobronchial invasion in patients with esophageal cancer (EC).

Methods

We prospectively included patients with pathologically confirmed EC from November 2018 to June 2021, who had baseline stage of T3-4N0-2M0 and restaging after neoadjuvant chemotherapy. All patients underwent contrast-enhanced CT and MRI of the thorax. Two independent blinded radiologists scored image quality and the presence of invasion. Agreements between the two readers were calculated using kappa test. The sensitivity, specificity, accuracy, positive predict value (PPV), and negative predict value (NPV) of MRI and CT in evaluating invasion were calculated. The net reclassification index (NRI) was used to evaluate the change in the number of patients correctly classified by MRI and CT.

Results

A total of 70 patients (64.8 ± 9.0 years; 53 men) were enrolled. Inter-reader agreements of image quality scores and presence of invasion by MRI and CT between the two readers were almost perfect (kappa > 0.80). The accuracy of MRI in evaluating thoracic aorta invasion was significantly higher than that of CT (reader 1: 90.0% vs. 71.4%; reader 2: 92.9% vs. 70.0%, respectively), and the accuracy of MRI in evaluating tracheobronchial invasion also was significantly higher than that of CT (reader 1: 92.9% vs. 72.9%; reader 2: 95.7% vs. 70.0%, respectively). NRI values were positive in both the evaluation of aorta and tracheobronchial invasion.

Conclusions

The accuracy of 3-T MRI in determining thoracic aorta and tracheobronchial invasion is significantly higher than that of CT.

Key Points

• 3.0-T MRI was significantly more accurate than CT in assessing invasion of the thoracic aorta in patients with esophageal cancer.

• 3.0-T MRI was also significantly more accurate than CT in assessing tracheobronchial invasion in patients with esophageal cancer.

• 3.0-T MRI has a higher diagnostic performance than CT in evaluating patients with suspected aortic or tracheobronchial invasion in esophageal cancer.

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Data Availability

The data that support the findings of this study are available from the corresponding author [Jinrong Qu] upon reasonable request.

Abbreviations

DWI:

Diffusion weighted imaging

EC:

Esophageal cancer

ESCC:

Esophageal squamous cell carcinoma

nCT:

Neoadjuvant chemotherapy

NPV:

Negative predict value

NRI:

Net reclassification index

PPV:

Positive predict value

References

  1. Siegel RL, Miller KD, Fuchs HE, Jemal A (2022) Cancer statistics, 2022. CA Cancer J Clin 72:7–33

    Article  PubMed  Google Scholar 

  2. Liang H, Fan JH, Qiao YL (2017) Epidemiology, etiology, and prevention of esophageal squamous cell carcinoma in China. Cancer Biol Med 14:33–41

    Article  PubMed  PubMed Central  Google Scholar 

  3. Miller KD, Nogueira L, Devasia T et al (2022) Cancer treatment and survivorship statistics, 2022. CA Cancer J Clin 72:409–436

    Article  PubMed  Google Scholar 

  4. Cong Z, Diao Q, Yi J et al (2014) Esophagectomy combined with aortic segment replacement for esophageal cancer invading the aorta. Ann Thorac Surg 97:460–466

    Article  PubMed  Google Scholar 

  5. de Nucci G, Petrone MC, Imperatore N et al (2021) Staging esophageal cancer: low EUS accuracy in t2n0 patients. Endosc Int Open 9:E313–E318

    Article  PubMed  PubMed Central  Google Scholar 

  6. Shim HI, Lee DH, Cho JH et al (2020) Comparing the accuracy of EUS and CT in staging of esophageal cancer. J Clin Oncol 38:286–286

    Article  Google Scholar 

  7. He LJ, Xie C, Wang ZX et al (2020) Submucosal saline injection followed by endoscopic ultrasound versus endoscopic ultrasound only for distinguishing between T1a and T1b esophageal cancer. Clin Cancer Res 26:384–390

    Article  CAS  PubMed  Google Scholar 

  8. Guo J, Wang Z, Qin J et al (2020) A prospective analysis of the diagnostic accuracy of 3 T MRI, CT and endoscopic ultrasound for preoperative T staging of potentially resectable esophageal cancer. Cancer Imaging 20:64

    Article  PubMed  PubMed Central  Google Scholar 

  9. Krill T, Baliss M, Roark R et al (2019) Accuracy of endoscopic ultrasound in esophageal cancer staging. J Thorac Dis 11:S1602–S1609

    Article  PubMed  PubMed Central  Google Scholar 

  10. Luo LN, He LJ, Gao XY et al (2016) Endoscopic ultrasound for preoperative esophageal squamous cell carcinoma: a meta-analysis. PLoS One 11

  11. Gu C, Yang X, Zhang X et al (2019) The prognostic significance of MRI-detected extramural venous invasion, mesorectal extension, and lymph node status in clinical T3 mid-low rectal cancer. Sci Rep 9:12523

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lord AC, D’Souza N, Shaw A et al (2020) MRI-diagnosed tumour deposits and EMVI status have superior prognostic accuracy to current clinical TNM staging in rectal cancer. Ann Surg. https://doi.org/10.1097/SLA.0000000000004499

    Article  PubMed  Google Scholar 

  13. Qu J, Wang Z, Qin J et al (2020) MRI features in differentiating mucosal high-grade neoplasia from early invasive squamous cell cancer of the esophagus. Eur Radiol 30:3455–3461

    Article  PubMed  Google Scholar 

  14. Zhang F, Qu J, Zhang H et al (2017) Preoperative T staging of potentially resectable esophageal cancer: a comparison between free-breathing radial VIBE and breath-hold Cartesian VIBE, with histopathological correlation. Transl Oncol 10:324–331

    Article  PubMed  PubMed Central  Google Scholar 

  15. Wang Z, Guo J, Qin J et al (2019) Accuracy of 3-T MRI for preoperative T staging of esophageal cancer after neoadjuvant chemotherapy, with histopathologic correlation. AJR Am J Roentgenol 212:788–795

    Article  PubMed  Google Scholar 

  16. Guo J, Wang Z, Qin J et al (2020) A prospective analysis of the diagnostic accuracy of 3 T MRI, CT and endoscopic ultrasound for preoperative T staging of potentially resectable esophageal cancer. Cancer imaging : the official publication of the International Cancer Imaging Society 20:64

    Article  PubMed  Google Scholar 

  17. Lee SL, Yadav P, Starekova J et al (2021) Diagnostic performance of MRI for esophageal carcinoma: a systematic review and meta-analysis. Radiology 299:583–594

    Article  PubMed  Google Scholar 

  18. Rice TW, Patil DT, Blackstone EH (2017) 8th edition AJCC/UICC staging of cancers of the esophagus and esophagogastric junction: application to clinical practice. Ann Cardiothorac Surg 6:119–130

    Article  PubMed  PubMed Central  Google Scholar 

  19. Cohen J, Korevaar D, Altman D et al (2016) STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration. BMJ Open 6:e012799

    Article  PubMed  PubMed Central  Google Scholar 

  20. 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  CAS  PubMed  Google Scholar 

  21. Picus D, Balfe DM, Koehler RE, Roper CL, Owen JW (1983) Computed tomography in the staging of esophageal carcinoma. Radiology 146:433–438

    Article  CAS  PubMed  Google Scholar 

  22. Wang J, Chen Q, Wu X et al (2017) Endoscopic ultrasound for preoperative staging of esophageal cancer: application value and problems encountered. WCJD 25:438

    Article  Google Scholar 

  23. Rice TW, Patil DT, Blackstone EH (2017) 8th edition AJCC/UICC staging of cancers of the esophagus and esophagogastric junction: application t o clinical practice. Ann Cardiothorac Surg 6:119–130

    Article  PubMed  PubMed Central  Google Scholar 

  24. Tsujimoto H, Matsumoto Y, Kumano I et al (2013) Distance between the esophageal tumor and the aorta measured by using the contrast-enhanced attenuation on computed tomography for predicting this tumor invading aorta. J Gastroenterol Hepatol 28:297–302

    Article  PubMed  Google Scholar 

  25. Panebianco V, Grazhdani H, Iafrate F et al (2006) 3D CT protocol in the assessment of the esophageal neoplastic lesions: can it improve TNM staging? Eur Radiol 16:414–421

    Article  CAS  PubMed  Google Scholar 

  26. Moschetta M, Ianora A, Marzullo A, Scardapane A, Angelelli G (2010) Vessel probe CT protocol in the study of esophageal carcinoma: can it improve preoperative T staging? Eur J Surg Oncol 36:663–669

    Article  CAS  PubMed  Google Scholar 

  27. Manabe T, Kawamitsu H, Higashino T et al (2004) Esophageal magnetic resonance fluoroscopy: optimization of the sequence. J Comput Assist Tomogr 28:697–703

    Article  PubMed  Google Scholar 

  28. Riddell A, Richardson C, Scurr E, Brown G (2006) The development and optimization of high spatial resolution MRI for imaging the oesophagus using an external surface coil. Br J Radiol 79:873–879

    Article  CAS  PubMed  Google Scholar 

  29. Qu J, Zhang Y, Lu S et al (2022) Quantitative RECIST derived from multiparametric MRI in evaluating response of esophageal squamous cell carcinoma to neoadjuvant therapy. Eur Radiol 32:7295–7306

    Article  PubMed  Google Scholar 

  30. Chu F, Liu Y, Liu Q et al (2022) Development and validation of MRI-based radiomics signatures models for prediction of disease-free survival and overall survival in patients with esophageal squamous cell carcinoma. Eur Radiol 32:5930–5942

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study has received funding by the Projects of the General Programs of the National Natural Science Foundation of China (No. 81972802, No. 82271979), Henan Province Medical Science and Technology Research Program Provincial Department to jointly build key projects (No. SBGJ202002021, No. LHGJ20200196), special funding of the Henan Health Science and Technology Innovation Talent Project (No. YXKC2020011), and Henan Province focuses on research and development and promotion (No. 212102310133).

Author information

Author notes

  1. Keke Zhao and Funing Chu are contributed equally.

Authors and Affiliations

  1. Department of Radiology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, No. 127 Dongming Road, Zhengzhou, 450008, Henan, China

    Keke Zhao, Funing Chu, Zhaoqi Wang, Hongkai Zhang, Shuang Lu, Zhengyan Jia, Hailiang Li & Jinrong Qu

  2. Department of Thoracic Surgery, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, Henan, China

    Yan Zheng

  3. Department of Pathology, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, Henan, China

    Qingxin Xia

  4. Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205-2196, USA

    Ihab R. Kamel

Authors
  1. Keke Zhao
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Corresponding author

Correspondence to Jinrong Qu.

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Guarantor

The scientific guarantor of this publication is Jinrong Qu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

The protocol was approved by Henan Cancer Hospital Review Board (NCT03635619) and informed consent was waived. All the authors have followed the applicable ethical standards to maintain the research integrity without any duplication, fraud, or plagiarism issues.

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• performed at one institution

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Zhao, K., Chu, F., Wang, Z. et al. Aorta and tracheobronchial invasion in esophageal cancer: comparing diagnostic performance of 3.0-T MRI and CT. Eur Radiol 33, 4962–4972 (2023). https://doi.org/10.1007/s00330-023-09425-2

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