Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
Department of Oncology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
Eur J Radiol. 2023 Sep;166:111001. doi: 10.1016/j.ejrad.2023.111001. Epub 2023 Jul 20.
To evaluate the added value of cine MR in addition to static MRI for T-Staging assessment of esophageal cancer (EC).
This prospective monocentric study included 54 patients (mean age 66.3 ± 9.4 years, 46 men) with histologically proven EC. They underwent MRI on a 3 T-scanner in addition to the standard workup. Acquisitions included static and cine sequences (steady-state-free-precession and real-time True-FISP during water ingestion). Three radiologists independently assessed T-staging and diagnosis confidence by reviewing (1) static sequences (S-MRI) and (2) adding cine sequences (SC-MRI). Inter-reader agreement was performed. MRI T-staging was correlated to reference standard T-staging (histopathology or consensus on endoscopic ultrasonography and imaging findings) and to clinical outcome by log-rank test.
Both S-MRI and SC-MRI T-staging showed a significant correlation with reference T-staging (rs = 0.667, P < 0.001). SC-MRI showed a slightly better performance in distinguishing T1-T3 from T4 with a sensitivity, specificity and AUC of 76.5% (95% CI: 50.1-93.2), 83.8% (68-93.8) and 0.801 (0.681-0.921) vs 70.6% (44-89.7), 83% (68-93.8) and 0.772 (0.645-0.899) for S-MRI. Compared to S-MRI, SC-MRI increased inter-reader agreement for T4a and T4b (κ = 0.403 and 0.498) and T-staging confidence.
MRI is accurate for T-staging of EC. The addition of cine sequences allows better differentiation between T1-T3 and T4 tumors with increased diagnostic confidence and inter-reader agreement.
评估电影磁共振成像（cine MR）在食管癌（EC） T 分期评估中对静态磁共振成像（MRI）的补充价值。
这项前瞻性单中心研究纳入了 54 例经组织学证实的 EC 患者（平均年龄 66.3 ± 9.4 岁，46 名男性）。他们在 3T 扫描仪上进行了 MRI 检查，此外还进行了标准检查。采集包括静态和电影序列（饮水时稳态自由进动和实时真实快速成像）。三位放射科医生通过（1）静态序列（S-MRI）和（2）添加电影序列（SC-MRI）独立评估 T 分期和诊断信心。进行了读者间一致性评估。MRI T 分期与参考标准 T 分期（组织病理学或内镜超声检查和影像学结果的共识）以及通过对数秩检验的临床结果相关。
S-MRI 和 SC-MRI 的 T 分期均与参考 T 分期有显著相关性（rs = 0.667，P < 0.001）。SC-MRI 在区分 T1-T3 和 T4 方面表现稍好，敏感性、特异性和 AUC 分别为 76.5%（95%CI：50.1-93.2）、83.8%（68-93.8）和 0.801（0.681-0.921），而 S-MRI 为 70.6%（44-89.7）、83%（68-93.8）和 0.772（0.645-0.899）。与 S-MRI 相比，SC-MRI 增加了 T4a 和 T4b （κ= 0.403 和 0.498）和 T 分期的读者间一致性和诊断信心。
MRI 对 EC 的 T 分期准确。添加电影序列可更好地区分 T1-T3 和 T4 肿瘤，提高诊断信心和读者间一致性。
