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Esophageal cancer characterization with pneumo-64-MDCT

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Abstract

Early diagnosis and accurate staging of esophageal cancer are both essential for therapeutic strategy planning. Endoscopic ultrasound, CT, and positron emission tomography have all been used in the preoperative staging of esophageal cancer separately or in various combinations. Each imaging method has its strengths and weaknesses. Depiction of the tumor’s anatomic location conditions the surgical strategy. Endoscopic ultrasound and PET have important advantages but neither provides information for surgical planning. CT scans have some limitations for hollow organ assessment in the absence of lumen distension, since the organ wall may be collapsed. Therefore, optimal esophageal distension could be very useful to overcome these limitations. This potential drawback is crucial at the level of the GE junction, a typically difficult region to evaluate. In order to optimize tumor visualization in the esophageal wall and in the GE junction, we developed a technique named pneumo-64-MDCT. We achieve maximum lumen distension, which better highlights the thickened areas in relation to the normal esophageal wall. At the present time, we have performed 200 studies with this technique and it proved useful, safe and accurate to identify esophageal wall thickening and to stage esophageal cancer. The additional stomach distension led to an adequate definition of both the upper and lower borders of the lesion in tumors located in the GE junction, which in turn was helpful to design the surgical approach.

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Authors and Affiliations

  1. Department of Radiology, Hospital Italiano, Universidad de Buenos Aires, Gascón 450, Buenos Aires, Argentina

    Marina Ulla, Ernestina María José Gentile, Ezequiel Levy Yeyati, Laura Frank & Ricardo Garcia Mónaco

  2. Department of Surgery, Hospital Italiano, Universidad de Buenos Aires, Buenos Aires, Argentina

    Demetrio Cavadas & Javier Ithurralde Argerich

Authors
  1. Marina Ulla
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  2. Ernestina María José Gentile
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  3. Demetrio Cavadas
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  4. Ezequiel Levy Yeyati
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  5. Laura Frank
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  6. Javier Ithurralde Argerich
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  7. Ricardo Garcia Mónaco
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Correspondence to Marina Ulla.

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Ulla, M., Gentile, E.M.J., Cavadas, D. et al. Esophageal cancer characterization with pneumo-64-MDCT. Abdom Imaging 37, 501–511 (2012). https://doi.org/10.1007/s00261-011-9784-z

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