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Esophageal cancer: evaluation with triple-phase dynamic CT--initial experience.

Abstract：

PURPOSE:To prospectively assess which phase of a triple-phase dynamic contrast material-enhanced multi-detector row computed tomography (CT) protocol is optimal for visualization of esophageal cancer. MATERIALS AND METHODS:The study was supported by the local ethical committee; all patients gave written informed consent. Thirty-one lesions in 28 consecutive patients (26 men, two women; mean age, 65 years; range, 53-87 years) with histopathologically confirmed esophageal cancer were evaluated with triple-phase dynamic CT performed at 5, 35, and 65 seconds (first arterial, second arterial, and venous phases) after attenuation of 200 HU was obtained at the descending aorta. Qualitative image analysis was performed to assess appearance and conspicuity of the tumor. Appearances of all 31 lesions were classified into three categories-not identifiable, focal enhancement with or without minimal (<1 cm) wall thickening, and focal mass lesion or obvious (>1 cm) wall thickening. Results were compared with surgical or endoscopic ultrasonographic findings. Quantitative assessment included regions-of-interest measurement of the tumor and normal esophageal wall and the difference between those measurements. A paired t test was used to determine which phase showed the highest tumor attenuation and tumor-to-normal esophageal wall attenuation differences. RESULTS:At visual assessment, 30 lesions were identified in the second arterial phase. Of these 30 lesions, eight were focal enhancements; the best conspicuity was during the second arterial phase. Furthermore, seven of these eight lesions were T1 cancers. The remaining 22 lesions were enhanced masses or wall thickening. Twenty-one of these 22 tumors also showed best conspicuity in the second arterial phase. The greatest attenuation of tumors in the second arterial phase was 130.0 HU, and the difference in attenuation between tumor and normal esophageal wall was 50.6 HU in the second arterial phase, which were significantly higher than those in the other two phases (P<.01, each). CONCLUSION:The second arterial phase of dynamic CT is the optimal phase for visualization of esophageal cancer.

journal_name

Radiology

journal_title

Radiology

authors

Umeoka S,Koyama T,Togashi K,Saga T,Watanabe G,Shimada Y,Imamura M

doi

10.1148/radiol.2393050222

subject

Has Abstract

pub_date

2006-06-01 00:00:00

pages

777-83

issue

eissn

0033-8419

issn

1527-1315

pii

2393050222

journal_volume

239

pub_type

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Esophageal cancer: evaluation with triple-phase dynamic CT--initial experience.