[Usefulness of Pneumo-64-MDCT in the presurgical evaluation of esophageal cancer].

BACKGROUND

Pre-surgical characterization and staging of esophageal and esophagogastric union cancer with only one imaging method could be useful for the therapeutic strategy.

OBJECTIVE

1. To evaluate the sensitivity of Pneumo-64-MSCT (PnCT64) in the diagnosis of esophageal-cardial wall thickening in correlation with anatomopathological and postsurgical findings. 2) To evaluate the usefulness of gastric distension in the presurgical planning of esophageal cancer, especially those located in the gastroesophageal junction.

METHODS

Twenty-four patients with endoscopic diagnosis of esophageal and cardial cancer were prospectively studied with PnCT64 before surgery. CT's were performed with a 64 row CT scanner and in order to achieve esophageal distension, CO2 was instilled with an automated insufflator through a Foley catheter. Mural thickening was evaluated as well as its scope, shape and anatomic location by using different type of reconstructions. PnCT64 findings were correlated with anatomopathological staging.

RESULTS

In 21 patients an asymmetric wall thickening was observed with a sensitivity of 86.4% in correlation with anatomopathological findings. Adequate gastroesophageal distension defining the limits of the lesions was achieved in all patients.

CONCLUSION

PnCT64 showed high sensitivity in the diagnosis of esophageal and cardial thickening. Gastric distension proved to be useful for the presurgical evaluation defining both upper and lower borders of the tumors located in the gastroesophageal junction.