Esophageal carcinoma: CT — staging of tumor infiltration

Abstract

The computed tomograms of 74 patients with histologically proven carcinomas of the esophagus, including the esophagogastric junction, were retrospectively evaluated. In 58 patients (78%) the CT findings could be compared with surgical and histologic results. Aortic infiltration was assumed in cases with contiguous contact of aorta and tumor on at least four CT slices (slice thickness: 8 mm) and a transverse “contact-angle” of more than 60 degrees. In this regard CT showed a sensitivity of 86% and a specificity of 92% according to surgery. Tracheo bronchial infiltration was suggested when compression or change of position of these structures was observed (sensitivity of 86%, specificity of 65%). Infiltration of the diaphragm was detected by CT with a sensitivity of 60% and a specificity of 88%. Infiltrations of pleura or pericardium could not be diagnosed by CT in our study. Consequently, CT is a valuable method to show aortic infiltration (negative predictive value, 95%; positive predictive value, 86%) and an infiltration of the tracheobronchial system (negative predictive value, 79%; positive predictive value, 75%) in patients with carcinoma of the esophagus.