Vessel probe CT protocol in the study of esophageal carcinoma: can it improve preoperative T staging?

This study aims to compare transverse images and vessel probe (VP) in MPR mode reconstructions obtained by 16-row MDCT with the histological findings in the preoperative T staging of esophageal cancer.

Thirty-one patients (23 M, 8 F, mean age 63.2) with endoscopic and histological diagnosis of esophageal carcinoma underwent CT examination. Esophageal lumen was distended by CO2 and a biphasic technique with 35 s and 70 s delay was used after intravenous injection of contrast material. Transverse and VP in MPR mode images were evaluated and the following parameters were considered: presence and location of the tumor; esophageal wall thickness and enhancement; depth of visceral wall invasion; periesophageal fat morphology and infiltration of adjacent organs. Preoperative staging was performed and then it was compared with the histological findings considered as reference standard.

Sensibility, negative predictive and accuracy values were 67%, 64% and 79% by using axial images for preoperative T staging, while the use of VP increased the previous values up to 83%, 78% and 89%, respectively.

In the preoperative staging of esophageal cancer, VP in MPR mode reconstructions obtained by 16-row MDCT increase the sensibility and diagnostic accuracy values in the T parameter evaluation compared with axial images.