Skip to main content
Log in

Tumour volume of resectable oesophageal squamous cell carcinoma measured with MRI correlates well with T category and lymphatic metastasis

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To determine association of gross tumour volume (GTV) of resectable oesophageal squamous cell carcinoma (SCC) measured on T2-weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE-T1WI) and diffusion-weighted imaging (DWI) with T category and lymphatic metastasis (LM).

Methods

Sixty oesophageal SCC patients underwent fat-suppressed T2WI, CE-T1WI and DWI with b values of 0, 500 and 800 s/mm2. GTV was measured on three sequences. Statistical analyses were performed to determine association of GTV with T category and LM.

Results

Spearman's rank correlation analysis showed positive association of GTV with T category and LM (all p values < 0.01). Differences in GTV were found between T1 and T2 or T3 categories shown by Kruskal-Wallis H and one-way ANOVA tests, and between T1/T2 and T3 and between tumours with and without LM by Mann-Whitney U tests (all p values < 0.05). Receiver operating characteristic analyses showed cut-off GTVs of 5.795, 5.276 and 10.11 cm3 on CE-T1WI could better differentiate T1 from T2 categories, T1 from T3, and T1-2 from T3 than those of 7.066, 7.045 and 8.504 cm3 on T2WI, of 5.793, 6.609 and 6.989 cm3 on DWI with b value of 500 s/mm2, and of 4.156, 4.519 and 4.985 cm3 with b value of 800 s/mm2, respectively. Cut-off of 10.462 cm3 on DWI with b value of 500 s/mm2 could better identify LM than of 12.38, 8.793 and 9.600 cm3 on T2WI, CE-T1WI and DWI with b value of 800 s/mm2, respectively.

Conclusions

GTVs on T2WI, CE-T1WI and DWI are associated with T category of and LM of oesophageal SCC.

Key Points

• GTV is associated with T category and lymphatic metastasis of oesophageal SCC

• GTV measured on contrast-enhanced T 1 -weighted imaging better identifies T category

• GTV measured on DWI with b value of 500 s/mm 2 better identifies lymphatic metastasis

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

EUS:

Endoscopic ultrasonography

GTV:

Gross tumour volume

ICC:

Intraclass correlation coefficient

LAVA:

Liver acquisition with volume acceleration

LM:

Lymphatic metastasis

SCC:

Squamous cell carcinoma

References

  1. Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:359–386

    Article  Google Scholar 

  2. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012. CA Cancer J Clin 65:87–108

    Article  Google Scholar 

  3. Hayes T, Smyth E, Riddell A, Allum W (2017) Staging in esophageal and gastric cancers. Hematol Oncol Clin North Am 31:427–440

    Article  Google Scholar 

  4. Li H, Chen TW, Li ZL et al (2012) Tumour size of resectable oesophageal squamous cell carcinoma measured with multidetector computed tomography for predicting regional lymph node metastasis and N stage. Eur Radiol 22:2487–2493

    Article  Google Scholar 

  5. Li H, Chen TW, Zhang XM et al (2013) Computed tomography scan as a tool to predict tumor T category in resectable esophageal squamous cell carcinoma. Ann Thorac Surg 95:1749–1755

    Article  Google Scholar 

  6. Créhange G, Bosset M, Lorchel F et al (2006) Tumor volume as outcome determinant in patients treated with chemoradiation for locally advanced esophageal cancer. Am J Clin Oncol 29:583–587

    Article  Google Scholar 

  7. Twine CP, Roberts SA, Lewis WG et al (2010) Prognostic significance of endoluminal ultrasound-defined disease length and tumor volume (EDTV) for patients with the diagnosis of esophageal cancer. Surg Endosc 24:870–878

    Article  Google Scholar 

  8. Bhutani MS, Barde CJ, Markert RJ, Gopalswamy N (2002) Length of esophageal cancer and degree of luminal stenosis during upper endoscopy predict T stage by endoscopic ultrasound. Endoscopy 34:461–463

    Article  CAS  Google Scholar 

  9. Giganti F, Ambrosi A, Petrone MC et al (2016) Prospective comparison of MR with diffusion-weighted imaging, endoscopic ultrasound, MDCT and positron emission tomography-CT in the pre-operative staging of oesophageal cancer: results from a pilot study. Br J Radiol 89:20160087

    Article  Google Scholar 

  10. Giganti F, Ambrosi A, Esposito A, Del Maschio A, De Cobelli F (2017) Oesophageal cancer staging: a minefield of measurements-author's reply. Br J Radiol 90:20170054

    Article  Google Scholar 

  11. Fleckenstein J, Jelden M, Kremp S et al (2016) The impact of diffusion-weighted MRI on the definition of gross tumor volume in radiotherapy of non-small-cell lung cancer. PLoS One 11:1–11

    Article  Google Scholar 

  12. Quaia E, Gennari AG, Ricciardi MC, Ulcigrai V, Angileri R, Cova MA (2016) Value of percent change in tumoral volume measured at T2-weighted and diffusion-weighted MRI to identify responders after neoadjuvant chemoradiation therapy in patients with locally advanced rectal carcinoma. J Magn Reson Imaging 44:1415–1424

    Article  Google Scholar 

  13. Rud E, Klotz D, Rennesund K et al (2014) Detection of the index tumour and tumour volume in prostate cancer using T2-weighted and diffusion-weighted magnetic resonance imaging (MRI) alone. BJU Int 114:E32–E42

    Article  Google Scholar 

  14. Liu G, Yang Z, Li T, Yang L, Zheng X, Cai L (2017) Optimization of b-values in diffusion-weighted imaging for esophageal cancer: measuring the longitudinal length of gross tumor volume and evaluating chemoradiotherapeutic efficacy. J Cancer Res Ther 13:748–755

    Article  CAS  Google Scholar 

  15. Hou DL, Shi GF, Gao XS et al (2013) Improved longitudinal length accuracy of gross tumor volume delineation with diffusion weighted magnetic resonance imaging for esophageal squamous cell carcinoma. Radiat Oncol 8:169

    Article  Google Scholar 

  16. Riddell AM, Allum WH, Thompson JN, Wotherspoon AC, Richardson C, Brown G (2007) The appearances of oesophageal carcinoma demonstrated on high resolution, T2-weighted MRI, with histopathological correlation. Eur Radiol 17:391–399

    Article  CAS  Google Scholar 

  17. Ajani JA, D'Amico TA, Almhanna K et al (2015) Esophageal and esophagogastric junction cancers, version 1. J Natl Compr Cancer Netw 13:194–227

    Article  CAS  Google Scholar 

  18. Edge SB, Byrd DR, Compton CC et al (2010) AJCC Cancer Staging Manual, 7th edn. Springer, New York

    Google Scholar 

  19. Inan N, Arslan A, Akansel G et al (2007) Diffusion-weighted imaging in the differential diagnosis of simple and hydatid cysts of the liver. AJR Am J Roentgenol 189:1031–1036

    Article  Google Scholar 

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

    Article  Google Scholar 

  21. Liang EY, Chan A, Chung SC, Metreweli C (1996) Short communication: esophageal tumour volume measurement using spiral CT. Br J Radiol 69:344–347

    Article  CAS  Google Scholar 

  22. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    Article  CAS  Google Scholar 

  23. Koo TK, Li MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 15:155–163

    Article  Google Scholar 

  24. Padhani AR, Koh DM, Collins DJ (2011) Whole-body diffusion-weighted MR imaging in cancer: current status and research directions. Radiology 261:700–718

    Article  Google Scholar 

  25. Sillah K, Pritchard SA, Watkins GR et al (2009) The degree of circumferential tumour involvement as a prognostic factor in oesophageal cancer. Eur J Cardiothorac Surg 36:368–373

    Article  Google Scholar 

  26. Wang BY, Goan YG, Hsu PK, Hsu WH, Wu YC (2011) Tumor length as a prognostic factor in esophageal squamous cell carcinoma. Ann Thorac Surg 91:887–893

    Article  Google Scholar 

  27. Murakami G, Sato I, Shimada K, Dong C, Kato Y, Imazeki T (1994) Direct lymphatic drainage from the esophagus into the thoracic duct. Surg Radiol Anat 16:399–407

    Article  CAS  Google Scholar 

  28. Kim DU, Lee JH, Min BH et al (2008) Risk factors of lymph node metastasis in T1 esophageal squamous cell carcinoma. J Gastroenterol Hepatol 23:619–625

    Article  Google Scholar 

  29. Haisley KR, Hart KD, Fischer LE et al (2016) Increasing tumor length is associated with regional lymph node metastases and decreased survival in esophageal cancer. Am J Surg 211:860–866

    Article  Google Scholar 

  30. Kadota T, Yano T, Fujita T, Daiko H, Fujii S (2017) Submucosal invasive depth predicts lymph node metastasis and poor prognosis in submucosal invasive esophageal squamous cell carcinoma. Am J Clin Pathol 148:416–426

    Article  Google Scholar 

  31. Foley KG, Hills RK, Berthon B et al (2018) Development and validation of a prognostic model incorporating texture analysis derived from standardised segmentation of PET in patients with oesophageal cancer. Eur Radiol 28:428–436

    Article  Google Scholar 

  32. Malhotra GK, Yanala U, Ravipati A, Follet M, Vijayakumar M, Are C (2017) Global trends in esophageal cancer. J Surg Oncol 115:564–579

    Article  Google Scholar 

Download references

Funding

This study has received funding by the National Natural Science Foundation of China (grant no. 81571645), the Sichuan Province Special Project for Youth Team of Science and Technology Innovation (grant no. 2015TD0029), and the Construction Plan for Scientific Research Team of Sichuan Provincial Colleges and Universities (grant no. 15TD0023).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tian-wu Chen.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Tian-wu Chen from the Department of Radiology, Affiliated Hospital of North Sichuan Medical College.

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 obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• diagnostic or prognostic study

• performed at one institution

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wu, L., Ou, J., Chen, Tw. et al. Tumour volume of resectable oesophageal squamous cell carcinoma measured with MRI correlates well with T category and lymphatic metastasis. Eur Radiol 28, 4757–4765 (2018). https://doi.org/10.1007/s00330-018-5477-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-018-5477-0

Keywords

Navigation