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Imaging strategies in the management of oesophageal cancer: what’s the role of MRI?

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

Abstract

Objectives

To outline the current role and future potential of magnetic resonance imaging (MRI) in the management of oesophageal cancer regarding T-staging, N-staging, tumour delineation for radiotherapy (RT) and treatment response assessment.

Methods

PubMed, Embase and the Cochrane library were searched identifying all articles related to the use of MRI in oesophageal cancer. Data regarding the value of MRI in the areas of interest were extracted in order to calculate sensitivity, specificity, predictive values and accuracy for group-related outcome measures.

Results

Although historically poor, recent improvements in MRI protocols and techniques have resulted in better imaging quality and the valuable addition of functional information. In recent studies, similar or even better results have been achieved using optimised MRI compared with other imaging strategies for T- and N-staging. No studies clearly report on the role of MRI in oesophageal tumour delineation and real-time guidance for RT so far. Recent pilot studies showed that functional MRI might be capable of predicting pathological response to treatment and patient prognosis.

Conclusions

In the near future MRI has the potential to bring improvement in staging, tumour delineation and real-time guidance for RT and assessment of treatment response, thereby complementing the limitations of currently used imaging strategies.

Key Points

• MRI’s role in oesophageal cancer has been somewhat limited to date.

• However MRI’s ability to depict oesophageal cancer is continuously improving.

• Optimising TN-staging, radiotherapy planning and response assessment ultimately improves individualised cancer care.

• MRI potentially complements the limitations of other imaging strategies regarding these points.

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Abbreviations

3DCRT:

three-dimensional conformal radiotherapy

ADC:

apparent diffusion coefficient

AJCC:

American Joint Committee on Cancer

CT:

computed tomography

CRT:

chemoradiotherapy

DCE:

dynamic contrast-enhanced

DWI:

diffusion-weighted imaging

DWIBS:

diffusion-weighted whole-body imaging with background body signal suppression

EBUS:

endobronchial ultrasound

EMR:

endomucosal resection

EUS:

endoscopic ultrasound

FDG-PET:

18F-fluorodeoxyglucose positron emission tomography

FNA:

fine needle aspiration

IMRT:

intensity modulated radiotherapy

MR:

magnetic resonance

MRI:

magnetic resonance imaging

RT:

radiotherapy

SPIO:

superparamagnetic iron oxide

STIR:

short tau inversion recovery

T1W:

T1-weighted

T2W:

T2-weighted

TSE:

turbo spin-echo

UICC:

International Union Against Cancer

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Authors and Affiliations

  1. Department of Surgery, G.04.228, University Medical Center Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands

    Peter S. N. van Rossum, Richard van Hillegersberg & Jelle P. Ruurda

  2. Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands

    Peter S. N. van Rossum, Frederiek M. Lever, Irene M. Lips, Astrid L. H. M. W. van Lier, Gert J. Meijer & Marco van Vulpen

  3. Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands

    Maarten S. van Leeuwen

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van Rossum, P.S.N., van Hillegersberg, R., Lever, F.M. et al. Imaging strategies in the management of oesophageal cancer: what’s the role of MRI?. Eur Radiol 23, 1753–1765 (2013). https://doi.org/10.1007/s00330-013-2773-6

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