Role of MR imaging of middle third esophageal carcinoma in determining resectability

Twenty-one patients with middle third esophageal carcinoma were prospectively evaluated by magnetic resonance imaging (MRI) to determine the resectability of the primary tumor. For 8 of the 21 patients, contrast medium was administered during the procedure. Evidences of aortic or tracheobronchial invasion shown on MRI were compared with surgico-pathologic findings, as well as mediastinal lymphadenopathy. Eleven patients (52%) had proved unresectable tumors (three cases of aortic invasion, five cases of tracheobronchial invasion and three cases of combined aortic and tracheobronchial invasion). In all eleven cases, these features were correctly detected by MRI. Two patients had false-positive findings on MRI. No patient had false-negative results. The sensitivity, specificity and accuracy were 100%, 80%, and 90% for MRI. Unsatisfactory results were obtained in evaluation of regional lymph node metastasis. Only two tumors in eight patients had good enhancement after contrast medium was given. We conclude MRI had a high accuracy in predicting resectability of tumors in patients with esophageal carcinoma.