Role of computed tomography in preoperative evaluation of esophageal carcinoma

The utility of computed tomography in pretherapy assessment of esophageal carcinoma is reviewed. Computed tomographic findings in 78 patients with histologically proved esophageal carcinoma were corelated with findings at surgery and histopathology. Computed tomography (CT) was found to be fairly accurate in assessing tumor extent, invasion of adjacent mediastinal structures and distant metastases but was of no help in detecting periesophageal lymph node involvement. The tracheobronchial tree invasion was detected with an overall accuracy of 96% whereas the same for invasion of aorta, percardium and gastroesophageal junction was 86%, 88% and 78% respectively. The sensitivity for the detection of periesophageal and perigastric lymphadenopathy was low (9% and 0% respectively) but was acceptably high in celiac lymphadenopathy (70%). CT is an excellent non invasive modality in pretherapy assessment of esophageal carcinoma and can guide the surgeon in determining the appropriate therapy.