Modern diagnostic evaluation and preoperative staging of esophageal cancer.

Esophageal carcinoma is a highly lethal disease with a dismal prognosis. Essential elements in the diagnosis of esophageal cancer are: a high index of suspicion; adequate knowledge of the precancerous conditions; optimal radiological examination; expert endoscopy with multiple biopsies and/or cytology; final staging including endoscopic ultrasonography, CT scan, MRI and, whenever appropriate, laryngo-bronchoscopy and ultrasonography with cytological puncture of cervical lymph nodes. This overview mainly concentrates on X-ray, endoscopy, endosonography and CT scanning. At present the routine use of MRI for preoperative staging cannot be recommended.