Radiographic and Endosonographic Staging in Esophageal Cancer

Imaging the posterior mediastinum: a multimodality approach

“…In the work-up of a malignant esophageal neoplasm, CXR and esophagography have been largely replaced by endoscopy (46). Endoscopy allows the evaluation of even small esophageal lesions and permits tissue sampling of both the esophageal wall and regional lymph nodes.…”

“…Endoscopy allows the evaluation of even small esophageal lesions and permits tissue sampling of both the esophageal wall and regional lymph nodes. Endoscopic ultrasound combined with fine-needle aspiration (EUS-FNA) helps in the assessment of regional lymph nodes, though it is limited to those located less than 2 cm from the esophageal lumen (46).…”

“…Once the histologic diagnosis is confirmed, CT of the chest and abdomen is recommended for assessing local and distant spread of disease (46). Oral and intravenous contrast material should be used to improve visualization of the esophageal lumen and mediastinal structures (46).…”

“…Oral and intravenous contrast material should be used to improve visualization of the esophageal lumen and mediastinal structures (46). In early stages, CT can show a soft-tissue mass or a focal thickening of the esophageal wall, which progresses to diffuse circumferential involvement in more advanced stages (Fig.…”

“…MRI does not substantially improve nodal staging, and its overall diagnostic performance does not exceed the above mentioned techniques (46,48). Malignant esophageal tumors usually produce intermediate signal intensity on T2-weighted images, unless they contain a high amount of extracellular mucin, which characteristically turns them hyperintense on these sequences (45).…”