CT scan and magnetic resonance diffusion‑weighted imaging in the diagnosis and treatment of esophageal cancer

Abstract

Value of computed tomography (CT) scan and diffusion-weighted imaging (DWI) in the diagnosis and treatment of esophageal cancer was investigated. Seventy-eight patients with esophageal cancer treated in Jinan Central Hospital (Jinan, China) from January 2013 to June 2014 were selected. All patients underwent CT scan and DWI examination, and their clinical history data were analyzed. DWI was conducted. The short-term curative effect and the 3-year survival rate of patients in the high apparent diffusion coefficient (ADC) value group and the low ADC value group were compared; ADC values in the complete remission (CR) group and the partial remission (PR) group were compared. The difference in value between the length of esophageal lesions and the length of pathological specimens measured by CT scan was significantly different from that detected via DWI examination with b=600, 800 and 1,000 sec/mm2, respectively (P<0.05). The diagnostic rate of esophageal cancer via CT scan was significantly lower than that via DWI examination (P<0.05). After radiotherapy, the clinical control rate in the high ADC value group was significantly higher than that in the low ADC value group, and the 3-year survival rate in the former was significantly higher than that in the latter (P<0.05). In the 2nd week during radiotherapy and at the end of radiotherapy, the ADC values in the CR group were significantly higher than those in the PR group (P<0.05). In the 2nd week during radiotherapy and at the end of radiotherapy, ADC values were used to predict the CR rate of radiotherapy for esophageal cancer, and the areas under the receiver operating characteristic (ROC) curve were 0.776 and 0.935, respectively. Compared with CT scan, DWI has higher diagnostic rate and higher sensitivity. The length of esophageal tumor measured by DWI is close to that of pathological entity, which can guide the delineation of the target area of esophageal cancer.

Diffusion-weighted MRI with ADC mapping for response prediction and assessment of oesophageal cancer: A systematic review

“…The basic characteristics regarding field strength, MRI acquisition parameter settings for diffusion weighting and ROI placement are shown in Table 1. MRI scans were performed on a field strength of 1.5 Tesla in nine studies [45][46][47][48][49][50][51][52][53]. 3.0 Tesla MRI scanners were used in four studies [54][55][56][57].…”

“…The risk of bias regarding patient selection was high in one study, which only included cT4 tumours [47]. Patient selection was scored unclear if an inclusion period and inclusion number were reported without explaining potential exclusions from analyses [45,50,[54][55][56].…”

“…Another study reported a clinical complete response on endoscopic assessment as the reference standard. This is not commonly used and was therefore scored as a high concern regarding applicability [50].…”

“…Four studies had high risk of bias concerning flow and timing. These studies evaluated the treatment effect by RECIST on imaging immediately after completion of CRT [47,50,52,58]. This was considered bias because of the considerable chance of wall thickening due to radiation-induced esophagitis shortly after completion of (chemo-)radiotherapy.…”

“…Fig. 2) [45,[47][48][49][50][52][53][54][55][56][57][58]. A good response was determined in the histopathologic specimen, or using RECIST in patients who did not undergo surgery.…”