Document Detail

Preoperative local staging of esophageal carcinoma using dual-phase contrast-enhanced imaging with multi-detector row computed tomography: value of the arterial phase images.
MedLine Citation:
PMID:  20498545     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To evaluate whether the accuracy of local extension (T-staging) of esophageal carcinoma could be improved with addition of arterial phase images by use of multi-detector row computed tomography. MATERIALS AND METHODS: The institutional review board approved this study, and all the subjects provided informed consent. Dual-phase (the arterial and venous phases) contrast-enhanced computed tomography was performed in 45 consecutive patients (39 men and 6 women; age range, 47-84 years) with 47 lesions of esophageal carcinoma who underwent surgical intervention. Two radiologists independently evaluated the T-staging of esophageal carcinoma on both phases. The T-staging on both the arterial and venous phase images was compared with the T-staging at histologic evaluation by means of a resected specimen (as the reference standard). Differences in the overall accuracy and sensitivity for the T-staging between the 2 phases were analyzed with the McNemar test. RESULTS: The analysis of the interobserver agreement for T-staging showed almost perfect agreement (kappa = 0.85 on the arterial phase and kappa = 0.93 on the venous phase). The overall accuracy in the arterial phase was significantly better than that in the venous phase (68% vs 51%, P < 0.01). The sensitivity values of the T-staging in the arterial phase were 0% in T1a, 71.4% in T1b, 12.5% in T2, 89.5% in T3, and 100% in T4. The sensitivity values in the venous phase were 0% in T1a, 14.3% in T1b, 0% in T2, 94.7% in T3, and 100% in T4. Statistical significance was apparent in the sensitivity of the T1b lesions. CONCLUSION: The arterial phase can improve the accuracy of T-staging of esophageal carcinomas, especially early-staged lesions.
Shigeaki Umeoka; Takashi Koyama; Go Watanabe; Tsuneo Saga; Masako Kataoka; Kaori Togashi; Hiroto Hatabu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of computer assisted tomography     Volume:  34     ISSN:  1532-3145     ISO Abbreviation:  J Comput Assist Tomogr     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7703942     Medline TA:  J Comput Assist Tomogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  406-12     Citation Subset:  IM    
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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MeSH Terms
Aged, 80 and over
Esophageal Neoplasms / pathology,  radiography*,  surgery
Image Enhancement
Middle Aged
Neoplasm Staging / methods*
Observer Variation
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*

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