Skip to main content

Preoperative Work-up: Conventional Radiology, Ultrasonography, CT Scan, and MRI

  • Chapter
Treatment of Esophageal and Hypopharyngeal Squamous Cell Carcinoma

Part of the book series: Updates in Surgery ((UPDATESSURG))

  • 922 Accesses

Abstract

The optimal assessment and staging of esophageal cancer (EC) is crucial as it has an important impact on patient selection with respect to appropriate treatment (surgery, neo-adjuvant therapy with or without surgery, palliative treatment) [1]. Preoperative evaluation requires knowledge of the esophageal anatomy and of the patterns of tumor spread. As mentioned in Chap. 2, the staging criteria for esophageal cancer include depth of local invasion, nodal involvement, and presence or absence of distant metastases. The various imaging modalities have different strengths and weaknesses in evaluating each of these criteria such that a combined multimodality imaging approach is usually necessary for an optimal assessment [2].

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

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kim TJ, Kim HY, Lee KW, Kim MS (2009) Multimodality assessment of esophageal cancer: preoperative staging and monitoring of response to therapy. RadioGraphics 29:403–421

    Article  PubMed  Google Scholar 

  2. Quint LE and Bogot NR (2008) Staging esophageal cancer. Cancer Imaging 8: S33–S42

    Article  PubMed Central  PubMed  Google Scholar 

  3. Ba-Ssalamah A, Zacherl J, Noebauer-Huhmann IM et al (2009) Dedicated multi-detector CT of the esophagus: spectrum of diseases. Abdom Imaging 34:3–18

    Article  PubMed  Google Scholar 

  4. Jang MK, Lee KS, Lee KS et al (2002) The spectrum of benign esophageal lesions: Imaging findings. Korean J Radiol 3:199–210

    Article  PubMed Central  PubMed  Google Scholar 

  5. Yamada A (1979) Radiologic assessment of respectability and prognosis in esophageal cancer. Gastrointestinal Radiol 4:213–218

    Article  CAS  Google Scholar 

  6. Mannell A (1982) Carcinoma of the esophagus. Curr Probl Surg 19:553–647

    Article  CAS  PubMed  Google Scholar 

  7. Levine MS and Halvorsen RA (2002) Carcinoma esofageo. In: Gore, Levine Eds. Trattato di Radiologia Gastro-intestinale Vol.1. Verduci Ed., Roma, pp 409–438

    Google Scholar 

  8. Siewert JR (2007) Esophageal carcinoma. Chirurg 78:475–484

    Article  CAS  PubMed  Google Scholar 

  9. Suga K, Shimizu K, Kawakami Y et al (2005) Lymphatic drainage from esophagogastric tract: feasibility of endoscopic CT lymphography for direct visualization of pathways. Radiology 237:952–960

    Article  PubMed  Google Scholar 

  10. Mandard AM, Chasle J, Marnay J et al (1981) Autopsy findings in 111 cases of esophageal cancer. Cancer 48:329–335

    Article  CAS  PubMed  Google Scholar 

  11. Glickman JN. II (2003) Pathology and pathologic staging of esophageal cancer. Semin Thorac Cardiovasc Surg 15:167–179

    Article  PubMed  Google Scholar 

  12. Lindell MM, Hill CA, Libshitz HI (1979) Esophageal cancer: radiographic chest findings and their prognostic significance. AJR 133:461–465

    Article  PubMed  Google Scholar 

  13. Gibbs JM, Chandrasekhar CA, Ferguson EC, Oldham SAA (2007) Lines and stripes: where did they go? From conventional radiography to CT. RadioGraphics 27:33–48

    Article  PubMed  Google Scholar 

  14. Whitten CR, Khan S, Munneke GJ, Grubnic S (2007) A Diagnostic Approach to Mediastinal Abnormalities. RadioGraphics 27:657–671

    Article  PubMed  Google Scholar 

  15. Gloyna RE, Zornoza J, Goldstein HM (1977) Primary ulcerative carcinoma of the esophagus. AJR 129:599–600

    Article  CAS  PubMed  Google Scholar 

  16. Yates CW Jr, Le Vene MA, Jensen KM (1977) Varicoid carcinoma of the esophagus. Radiology 122:605–608

    Article  PubMed  Google Scholar 

  17. Mori M, Mimori K, Sadanaga N et al (1994) Polypoid carcinoma of th esophagus. Jpn J Cancer Res 85:1131–1136

    Article  CAS  PubMed  Google Scholar 

  18. Buck JL (2001) Neoplastic and non-neoplastic tumors of the esophagus. Eur Radiol 11:S97–S103

    Google Scholar 

  19. Martinoli C, Givagnorio F, Derchi LE (2006) Anatomia ecografia normale del tratto gastroenterico. In: Arienti V (ed) Ecografia clinica del tratto gastroenterico. Unimedia srl-Athena srl, Modena, pp 75–84

    Google Scholar 

  20. Esen G (2006) Ultrasound of superficial lymph nodes. Eur J Radiol 58:345–359

    Article  PubMed  Google Scholar 

  21. de Bondt RBJ, Nelemans PJ, Hofmana PAM et al (2007) Detection of lymph node metastases in head and neck cancer: A meta-analysis comparing US, USgFNAC, CT and MR imaging. Eur J Radiol 64:266–272

    Article  PubMed  Google Scholar 

  22. Solbiati L, Charboneau JW, Osti V et al (2005) The thyroid gland. In: Rumack CM, Wilson SR, Charboneau JW (eds) Diagnostic ultrasound, 3rd edn. Mosby, St. Louis, pp 735–770

    Google Scholar 

  23. Vitale F, Arienti V (2006) Semeiotica ecografica. In: Arienti V (ed) Ecografia clinica del tratto gastroenterico. Unimedia srl-Athena srl Modena, pp 109–118

    Google Scholar 

  24. Doldi SB, Lattuada E, Zappa MA et al (1997) Ultrasonographic imaging of neoplasms of the cervical esophagus. Hepatogastroenterology 44:724–726

    CAS  PubMed  Google Scholar 

  25. Tanomkiat W, Chongchitnan P (1999) Transabdominal sonography of gastroesophageal junctions. J Clin Ultrasound 27:505–512

    Article  CAS  PubMed  Google Scholar 

  26. Eckardt VF, Schmitt T, Kanzler G (2004) Transabdominal ultrasonography in achalasia. Scan J Gastroenterol 39:634:637

    Article  CAS  Google Scholar 

  27. Solbiati L, Osti V, Cova L, Tonolini M (2002) Ultrasound of thyroid, parathyroid glands and neck lymph nodes. In: Ultrasound Categorial Course ECR 2002 Beart LA Ed, Eur Radiol Supplement Springer-Verlag, pp 320–333

    Google Scholar 

  28. Onbas O, Eroglu A, Kantarci M et al (2006) Preoperative staging of esophageal carcinoma with multidetector CT and virtual endoscopy. Eur J Radiol 57:90–95

    Article  PubMed  Google Scholar 

  29. Mazzeo S, Caramella D, Gennai A et al (2004) Multidetector CT and virtual endoscopy in the evaluation of the esophagus. Abdom Imaging 29:2–8

    Article  CAS  PubMed  Google Scholar 

  30. Panebianco V, Grazhdani H, Iafrate F et al (2006) 3D CT protocol in the assessment of the esophageal neoplastic lesions: can it improve TNM staging? Eur Radiol 16:414–421

    Article  CAS  PubMed  Google Scholar 

  31. Carrascosa P, Capunãy C, Lòpez EM et al (2009) Esophageal stenosis: three dimensional multidetector CT and virtual endoscopy. Abdom Imaging 34:19–25

    Article  PubMed  Google Scholar 

  32. Ulla M, Cavadas D, Munõz I et al (2010) Esophageal cancer: pneumo-64-MDCT. Abdom Imaging 35:383–389

    Article  PubMed  Google Scholar 

  33. Kumano S, Tsuda T, Tanaka H et al (2007) Preoperative evaluation of perigastric vascular anatomy by 3-dimensional computed tomographic angiography using 16-channel multidetector-row computed tomography for laparoscopic gastrectomy in patients with early gastric cancer. J Comput Assist Tomogr 31:93–97

    Article  PubMed  Google Scholar 

  34. Rice TW (2000) Clinical staging of esophageal carcinoma. CT, EUS, and PET. Chest Surg Clin N Am 10:471–485

    CAS  PubMed  Google Scholar 

  35. Diederich S (2007) Staging of oesophageal cancer. Cancer Imaging 7:S63–S66

    Article  PubMed Central  PubMed  Google Scholar 

  36. Picus D, Balfe DM, Koehler RE et al (1983) Computed tomography in the staging of esophageal carcinoma. Radiology 146:433–438

    Article  CAS  PubMed  Google Scholar 

  37. Takashima S, Takeuchi N, Shiozaki H et al (1991) Carcinoma of the esophagus: CT vs MR imaging in determining resectability. AJR Am J Roentgenol 156:297–302

    Article  CAS  PubMed  Google Scholar 

  38. Lehr L, Rupp N, Siewert JR (1988) Assessment of resectability of esophageal cancer by computed tomography and magnetic resonance imaging. Surgery 103:344–350

    CAS  PubMed  Google Scholar 

  39. Rankin S (1990) The role of computerized tomography in the staging of oesophageal cancer. Clin Radiol 42:152–153

    Article  CAS  PubMed  Google Scholar 

  40. Daffner RH, Halber MD, Postlethwait RW et al (1979) CT of the esophagus. II. Carcinoma. AJR Am J Roentgenol 133:1051–1055

    Article  CAS  PubMed  Google Scholar 

  41. Marzola MC, de Manzoni G, Grassetto G et al (2010) Extended staging of oesophageal cancer using FDG-PET. A critical appraisal. Eur J Radiol, doi: 10.1016/j.ejrad2010.10.018

    Google Scholar 

  42. Mortensen MB, Edwin B, Hunerbein M et al (2007) Impact of endoscopic ultasonography (EUS) on surgical decision-making in upper gastrointestinal tract cancer: an international multicenter study. Surg Endosc 21:431–438

    Article  CAS  PubMed  Google Scholar 

  43. Kumbasar B (2002) Carcinoma of esophagus: radiologic diagnosis and staging. Eur J Radiol 42:170–180

    Article  PubMed  Google Scholar 

  44. Schroder W, Baldus SE, Monig SP et al (2002) Limph node staging of esophageal squamous cell carcinoma in patients with and without neoadjuvant radiochemotherapy: histo-morphologic analysis. World J Surg 26:584–587

    Article  PubMed  Google Scholar 

  45. Dorfman RE, Alpern MB, Gross BH, Sandler MA (1991) Upper abdominal lymph nodes: criteria for normal size determined with CT. Radiology 180:319–322

    Article  CAS  PubMed  Google Scholar 

  46. Fultz PJ, Feins RH, Strang JG, et al (2002) Detection and diagnosis of nonpalpable supraclavicular lymphnodes in lung cancer at CT and US. Radiology 222:245–251

    Article  PubMed  Google Scholar 

  47. Block MI, Patterson GA, Sundaresan RS et al(1997) Improvement in staging of esophageal cancer with the addition of positron emission tomography. Ann Thorac Surg 64:770–777

    Article  CAS  PubMed  Google Scholar 

  48. Kato H, Kuwano H, Nakajima M et al (2002) Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma. Cancer 94:921–928

    Article  PubMed  Google Scholar 

  49. Souquet JC, Napoleon B, Pujol B et al (1994) Endoscopic ultrasonography in the preoperative staging of esophageal cancer. Endoscopy 26:764–766

    Article  CAS  PubMed  Google Scholar 

  50. van Vliet EPM, Heijenbrok-Kal MH, Hunink MGM et al (2008) Staging investigations for oesophageal cancer: a meta-analysis. British J Cancer 98: 547–557

    Article  Google Scholar 

  51. Kuszyk BS, Bluemke DA, Urban BA et al (1996) Portalphase contrast-enhanced helical CT for the detection of malignant hepatic tumors: sensitivity based on comparison with intraoperative and pathologic findings. AJR Am J Roentgenol 166:91–95

    Article  CAS  PubMed  Google Scholar 

  52. Jones EC, Chezmar JL, Nelson RC, Bernardino ME (1992) The frequency and significance of small (less than or equal to 15 mm) hepatic lesions detected by CT. AJR Am J Roentgenol 158:535–539

    Article  CAS  PubMed  Google Scholar 

  53. Schwartz LH, Gandras EJ, Colangelo SM et al (1999) Prevalence and importance of small hepatic lesions found at CT in patients with cancer. Radiology 210:71–74

    Article  CAS  PubMed  Google Scholar 

  54. Kato H, Miyazaki T, Nakajima M et al (2005) The incremental effect of positron emission tomography on diagnostic accuracy in the initial staging of esophageal carcinoma. Cancer 103:148–156

    Article  PubMed  Google Scholar 

  55. Giovagnoni A, Valeri G, Ferrara C (2002) MRI of esophageal cancer. Abdom Imaging 27:361–366

    Article  CAS  PubMed  Google Scholar 

  56. Wu LF, Wang BZ, Feng JL et al (2003) Preoperative TN staging of esophageal cancer: Compaison of miniprobe ultrasonography, spial CT and MRI. Wordl J Gastroenterol 9:219–224

    Google Scholar 

  57. Jamil LH, Gill KRS and Wallace MB (2008) Staging and restaging of advanced esophageal cancer. Current Opinion in Gastroenterology 24:530–534

    Article  PubMed  Google Scholar 

  58. Riddell AM, Richardson C, Scurr E, Brown G (2006) The development and optimization of high spatial resolution MRI for imaging the oesophagus using an external surface coil. Br J Radiol 79: 873–879

    Article  CAS  PubMed  Google Scholar 

  59. Riddell AM, Allum WH, Thompson JN et al (2007) The appearances of oesophageal cancinoma demonstrated oh high-resolution T2-weighted MRI, with histopathological correlation. Eur Radiol 17:391–399

    Article  CAS  PubMed  Google Scholar 

  60. Inui K, Nakazawa S, Yoshino J et al (1995) Endoscopic MRI: preliminary results of a new technique for visualization and staging of gastrointestinal tumors. Endoscopy 27:480–485

    Article  CAS  PubMed  Google Scholar 

  61. Kulling D, Feldman DR, Kay CL et al (1998) Local staging of esophageal cancer using endoscopic magnetic resonance imaging: prospective comparison with endoscopic ultrasound. Endoscopy 30:745–749

    Article  CAS  PubMed  Google Scholar 

  62. Dave UR, Williams AD, Wilson JA et al (2004) Esophageal cancer staging with endoscopic MR imaging: pilot study. Radiology 230:281–286

    Article  PubMed  Google Scholar 

  63. Yamada I, Murata Y, Izumi Y et al (1997) Staging of esophageal carcinoma in vitro with 4.7-T MR imaging. Radiology 204:521–526

    Article  CAS  PubMed  Google Scholar 

  64. Yamada I, Izumi Y, Kawano T et al (2001) Superficial esophageal carcinoma: an in vitro study of high-resolution MR imaging at 1.5 T. J Magn Reson Imaging 13:225–231

    Article  CAS  PubMed  Google Scholar 

  65. Riddell AM, Davies DC, Allum WH et al (2007) High-resolution MRI in evaluation of surgical anatomy of the esophagus and posterior mediastinum. AJR Am J Roentgenol 188:W37–W43

    Article  CAS  PubMed  Google Scholar 

  66. Nishimura H, Tanigawa N, Hiramatsu M et al (2006) Preoperative esophageal cancer staging: magnetic resonance imaging of lymph node with ferumoxtran-10, an ultrasmallsuperparamagnetic iron oxide. J Am Coll Surg 202:604–611

    Article  PubMed  Google Scholar 

  67. Sigal R, Vogl T, Casselman J et al (2002) Lymph node metastases from head and neck squamous cell carcinoma: MR i1aging with ultrasmall superparamagnetic iron oxide particles (Sinerem MR) — results of a phase-III multicenter clinical trial. Eur Radiol 12:1104–1113

    Article  CAS  PubMed  Google Scholar 

  68. Harisinghani M, Saksena M, Hahn P et al (2006) Ferumoxtran-10-enhanced mr lymphangiography: does contrast-enhanced imaging alone suffice for accurate lymph node characterization? AJR Am J Roentgenol 186:144–148

    Article  PubMed  Google Scholar 

  69. Saksena M, Harisinghani M, Hahn P et al (2006) Comparison of lymphotropic nanoparticleenhanced MRI sequences in patients with various primary cancers. AJR Am J Roentgenol 187:W582–W588

    Article  PubMed  Google Scholar 

  70. 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  PubMed  Google Scholar 

  71. Alper F, Turkyilmaz A, Kurtcan S et al (2010) Effectiveness of the STIR turbo spin—echo sequence MR imaging in evaluation of lymphadenopathy in esophageal cancer. Eur J Radiol. doi:10.1016/j.ejrad.2010.08.003

    Google Scholar 

  72. Kelsen DP, Ginsberg R, Pajak TF et al (1998) Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer. N Engl J Med 339:1979–1984

    Article  CAS  PubMed  Google Scholar 

  73. Ancona E, Ruol A, Santi S et al (2001) Only pathologic complete response to neoadjuvant chemotherapy improves significantly the long term survival of patients with resectable esophageal squamous cell carcinoma: final report of a randomized, controlled trial of preoperative chemotherapy versus surgery alone. Cancer 91:2165–2174

    Article  CAS  PubMed  Google Scholar 

  74. Bruzzi JF, Munden RF, Truong MT et al (2007) PET-CTof esophageal cancer: its role in clinical management. RadioGraphics 27:1635–1652

    Article  PubMed  Google Scholar 

  75. Westerterp M, van Westreenen HL, Reitsma JB et al (2005) Esophageal cancer: CT, endoscopic US, and FDG PET for assessment of response to neoadjuvant therapy—systematic review. Radiology 236:841–851

    Article  PubMed  Google Scholar 

  76. Swisher SG, Maish M, Erasmus JJ et al (2004) Utility of PET, CT, and EUS to identify pathologic responders in esophageal cancer. Ann Thorac Surg 78:1152–1160

    Article  PubMed  Google Scholar 

  77. Cerfolio RJ, Bryant AS, Ohja B et al (2005) The accuracy of endoscopic ultrasonography with fine-needle aspiration, integrated positron emission tomography with computed tomography, and computed tomography in restaging patients with esophageal cancer after neoadjuvant chemoradiotherapy. J Thorac Cardiovasc Surg 129:1232–1241

    Article  PubMed  Google Scholar 

  78. Hayano K, Okazumi S, Shuto K et al (2007) Perfusion CT can predict the response to chemoradiation therapy and survival in esophageal squamous cell carcinoma: initial clinical results. Oncol Rep 18:901–908

    PubMed  Google Scholar 

  79. Makari Y, Takushi Y, Yuichiro D et al (2007) Correlation between tumor blood flow assessed by perfusion CT and effect of neoadjuvant therapy in advanced esophageal cancers. J Surg Oncol 96:220–229

    Article  PubMed  Google Scholar 

  80. Chen TW, Yang ZG, Li Y et al (2009) Quantitative assessment of first-pass perfusion of oesophageal squamous cell carcinoma using 64-section MDCT: initial observation. Clinical Radiology 64:38–45

    Article  CAS  PubMed  Google Scholar 

  81. Chen TW, Yang ZG, Li Y et al (2010) Whole tumour first-pass perfusion using a low-dose method with 64-section multidetector row computed tomography in oesophageal squamous cell carcinoma. Eur J Radiol. doi:10.1016/j.ejrad.2010.07.006

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Italia

About this chapter

Cite this chapter

Montemezzi, S., Cenzi, D., Motton, M., Re, T.J. (2012). Preoperative Work-up: Conventional Radiology, Ultrasonography, CT Scan, and MRI. In: de Manzoni, G. (eds) Treatment of Esophageal and Hypopharyngeal Squamous Cell Carcinoma. Updates in Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-2330-7_3

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2330-7_3

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2329-1

  • Online ISBN: 978-88-470-2330-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics