Zhang Fengguang, Qu Jinrong, Zhang Hongkai, Liu Hui, Qin Jianjun, Ding Zhidan, Li Yin, Ma Jie, Zhang Zhongxian, Wang Zhaoqi, Zhang Jianwei, Zhang Shouning, Dong Yafeng, Grimm Robert, Kamel Ihab R, Li Hailiang
Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
Transl Oncol. 2017 Jun;10(3):324-331. doi: 10.1016/j.tranon.2017.02.006. Epub 2017 Mar 19.
To compare the T staging of potentially resectable esophageal cancer using free-breathing radial VIBE (r-VIBE) and breath-hold Cartesian VIBE (C-VIBE), with pathologic confirmation of the T stage.
Fifty patients with endoscopically proven esophageal cancer and indeterminate T1/T2/T3 stage by CT scan were examined on a 3-T scanner. The MRI protocol included C-VIBE at 150 seconds post-IV contrast, immediately followed by a work-in-progress r-VIBE with identical spatial resolution (1.1 mm × 1.1 mm × 3.0 mm). Two independent readers assigned a T stage on MRI according to the 7th edition of UICC-AJCC TNM Classification, and postoperative pathologic confirmation was considered the gold standard. Interreader agreement was also calculated.
The T staging agreement between both VIBE techniques and postoperative pathologic T staging was 52% (26/50) for C-VIBE, 80% (40/50) for r-VIBE for reader 1, and 50% (25/50), 82% (41/50) for reader 2, respectively. For the esophageal cancer with invading lamina propria, muscularis mucosae, or submucosa (T1 stage), r-VIBE achieved 86% (12/14) agreement for both readers 1 and 2. For invasion of muscularis propria (T2 stage), r-VIBE achieved 83% (25/30) for both readers 1 and 2, whereas for the invasion of adventitia (T3 stage), r-VIBE could only achieve agreement in 50% (3/6) and 67% (4/6) for readers 1 and 2, respectively.
Contrast-enhanced free-breathing r-VIBE is superior to breath-hold CVIBE in T staging of potentially resectable esophageal cancer, especially for T1 and T2.
比较自由呼吸下的径向容积内插屏气检查法（r-VIBE）和屏气笛卡尔容积内插屏气检查法（C-VIBE）对潜在可切除食管癌的T分期，并通过病理检查确认T分期。
50例经内镜证实为食管癌且CT扫描T分期为不确定的T1/T2/T3期患者在3T扫描仪上接受检查。MRI方案包括静脉注射造影剂后150秒时的C-VIBE序列，随后立即进行空间分辨率相同（1.1mm×1.1mm×3.0mm）的尚在研究阶段的r-VIBE序列。两名独立阅片者根据国际抗癌联盟（UICC）-美国癌症联合委员会（AJCC）TNM分类第7版对MRI图像进行T分期，术后病理检查结果被视为金标准。同时计算阅片者间的一致性。
对于C-VIBE，两种容积内插屏气检查法与术后病理T分期之间的一致性为52%（26/50）；对于阅片者1，r-VIBE的一致性为80%（40/50）；对于阅片者2，一致性分别为50%（25/50）和82%（41/50）。对于侵犯固有层、黏膜肌层或黏膜下层的食管癌（T1期），阅片者1和阅片者2对r-VIBE的一致性均达到86%（12/14）。对于侵犯固有肌层（T2期），阅片者1和阅片者2对r-VIBE的一致性均达到83%（25/30）；而对于侵犯外膜（T3期），阅片者1和阅片者2对r-VIBE的一致性分别仅为50%（3/6）和67%（4/6）。
在潜在可切除食管癌的T分期中，对比增强自由呼吸下的r-VIBE优于屏气的C-VIBE，尤其是对于T1和T2期。
